Page 1

ACA/FAMILY MEDICAID 201-4 Healthy Montana Kids Plus (ACA HMK Plus)

Supersedes: ACA/Family Medicaid 07/01/2016 Reference: 42 CFR 435.118; 42 CFR 435.926; ARM 37.82.101, .701; MCA 53-6-131; 42 USC 1396b Overview: Children from birth through age 18 may be eligible for HMK Plus coverage through the end of the month they turn 19. Countable income must be at or below 143% FPL (ACA FMA 005 Table of Standards- Healthy Montana Kids Program-Income). NON-FINANCIAL CRITERIA: Medicaid standard nonfinancial requirements are listed in section CMA 300 Non- Financial Overview. In addition to the standard criteria that apply to all Medicaid programs, the following non-financial criteria are specific to ACA HMK Plus: • Child must be under age 19 CONTINUOUS ELIGIBILITY: Children eligible for HMK Plus have a 12-month continuous span in which they remain eligible, regardless of changes in household circumstances. The span begins the first day of the application month and continues through the last day of the 12th month. CONTINUOUS ELIGIBILITY ENDS IF: 1) The child is no longer a Montana resident, 2) The child or the child’s representative requests closure, 3) The child dies, 4) The child turns 19 yrs old, or 5) If the agency determines that eligibility was erroneously granted at the most recent determination or renewal of eligibility due to: a) Agency error or b) Fraud, abuse or perjury attributed to the child or the child’s representative