101.14.02 DEEMED ELIGIBLE INFANTS

Official source

A deemed eligible infant is a child whose mother was eligible for Medicaid in the child’s birth month; however, there is no requirement that the child remain with the mother. The deemed eligible child has continuous Medicaid eligibility for a 13-month period from his birth month through the month of the first birthday unless one of the above early termination reasons is applicable. Specialists must ensure deemed eligible children are not: • Terminated prior to completion of the 13th month of Medicaid eligibility; or • Changed from Medicaid to CHIP prior to completion of the 13th month of eligibility, unless the parent or other responsible person voluntarily requests early Medicaid termination. The deemed child’s eligibility start date should always be his birth month, regardless of the date the agency authorizes eligibility for the child. To terminate eligibility at the end of the deemed period or to make a timely program change from Medicaid to CHIP, the child’s time span begin date should be set for the month following the month of the first birthday. If the mother is not eligible for Medicaid at the time her child is born, she may apply for Medicaid for herself and her newborn. The application must be filed timely for Medicaid to be retroactive to the birth of the child, i.e., an application must be filed by the end of the 3rd month following the birth month of the child. If all eligibility factors are met, the mother and newborn may be eligible for up to 3 months prior to the month the Medicaid application is filed. If the mother and newborn are determined eligible, the mother will be covered throughout her post-partum period and the newborn will be eligible for 12 continuous months.

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101.14.02 DEEMED ELIGIBLE INFANTS

Official source

A deemed eligible infant is a child whose mother was eligible for Medicaid in the child’s birth month; however, there is no requirement that the child remain with the mother. The deemed eligible child has continuous Medicaid eligibility for a 13-month period from his birth month through the month of the first birthday unless one of the above early termination reasons is applicable. Specialists must ensure deemed eligible children are not: • Terminated prior to completion of the 13th month of Medicaid eligibility; or • Changed from Medicaid to CHIP prior to completion of the 13th month of eligibility, unless the parent or other responsible person voluntarily requests early Medicaid termination. The deemed child’s eligibility start date should always be his birth month, regardless of the date the agency authorizes eligibility for the child. To terminate eligibility at the end of the deemed period or to make a timely program change from Medicaid to CHIP, the child’s time span begin date should be set for the month following the month of the first birthday. If the mother is not eligible for Medicaid at the time her child is born, she may apply for Medicaid for herself and her newborn. The application must be filed timely for Medicaid to be retroactive to the birth of the child, i.e., an application must be filed by the end of the 3rd month following the birth month of the child. If all eligibility factors are met, the mother and newborn may be eligible for up to 3 months prior to the month the Medicaid application is filed. If the mother and newborn are determined eligible, the mother will be covered throughout her post-partum period and the newborn will be eligible for 12 continuous months.