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(b) Child Born to a MA-Enrolled Mother

Newborn (NB) are presumptively eligible for MA for a period up to 15 months if the mother is enrolled as a Maryland MA recipient on the date of the newborn’s birth. The NB’s MA coverage is tied to the mother’s MA enrollment for the date of birth. Therefore, an application and determination of the newborn’s eligibility are not required in order to add the newborn to the mother’s currently eligible Assistance Unit (AU). Coverage of the newborn under this policy applies irrespective of any ineligibility factor that may pertain to the newborn, except that the newborn must be a Maryland resident.

If the mother is determined eligible for MA or the Maryland Children’s Health Program (MCHP) for a certification period including the newborn’s birth, the child is certified in coverage group P03, unless the mother was eligible in coverage group P11. Then, the newborn is certified in coverage group P12. The presumptive eligibility for the newborn applies even if:

The mother is determined eligible for the date of birth after the fact; or The mother is eligible in the X-track for ineligible or illegal aliens.

The newborn continues to be presumptively eligible in coverage group P03 or P12 for one year from the month of birth, unless the newborn moves from Maryland, dies, or becomes eligible in a different MA coverage group (e.g., T-track for long term care or E-Track for foster care or subsidized adoption). Therefore, the newborn retains eligibility in P03 or P12 even if the mother loses MA eligibility or the baby moves out of the mother’s household during the baby’s 15- month certification period. After 15 months of MA, a Redetermination must be conducted.