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ACA/FAMILY MEDICAID 201-5 ACA Healthy Montana Kids (HMK)

Supersedes: FMA 201-5 (12/01/2022) Reference: 42 CFR 457.310; 42 CFR 457.342; ARM Chapter 37.79 Overview: Children from birth through age 18 may be eligible for HMK coverage, if their household’s countable income exceeds the HMK Plus standard, but is equal to or less than 261% FPL (ACA FMA 005 Table of Standards- Healthy Montana Kids Program- Income). Children born to women receiving HMK have coverage (through their mother’s policy) during the ﬁrst 31 days after their birth. NON-FINANCIAL CRITERIA: Standard nonﬁnancial requirements are listed in section CMA 300 Non-Financial Overview. In addition to the standard criteria that apply to all Medicaid and HMK recipients, the following nonﬁnancial criteria are speciﬁc to ACA HMK, the child: 1. Must be under age 19, 2. Cannot reside in an institution for mental disease, 3. Cannot be an inmate of a public institution, and 4. Cannot have creditable health insurance CREDITABLE COVERAGE: The following are not considered creditable health insurance coverage: 1. Accident-only insurance policies, 2. Tribal or Indian Health Services (IHS), 3. Healthy Montana Kids Plus (HMK Plus) or Medicaid, 4. Mental Health Services Plan (MHSP), 5. School insurance purchased so a child can participate in school-related activities, 6. Children’s Special Health Services (CSHS), and 7. Speciﬁc illness (e.g., cancer) or body parts (e.g., dental or vision) insurance.

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Official source

ACA/FAMILY MEDICAID 201-5 ACA Healthy Montana Kids (HMK)

Supersedes: FMA 201-5 (12/01/2022) Reference: 42 CFR 457.310; 42 CFR 457.342; ARM Chapter 37.79 Overview: Children from birth through age 18 may be eligible for HMK coverage, if their household’s countable income exceeds the HMK Plus standard, but is equal to or less than 261% FPL (ACA FMA 005 Table of Standards- Healthy Montana Kids Program- Income). Children born to women receiving HMK have coverage (through their mother’s policy) during the ﬁrst 31 days after their birth. NON-FINANCIAL CRITERIA: Standard nonﬁnancial requirements are listed in section CMA 300 Non-Financial Overview. In addition to the standard criteria that apply to all Medicaid and HMK recipients, the following nonﬁnancial criteria are speciﬁc to ACA HMK, the child: 1. Must be under age 19, 2. Cannot reside in an institution for mental disease, 3. Cannot be an inmate of a public institution, and 4. Cannot have creditable health insurance CREDITABLE COVERAGE: The following are not considered creditable health insurance coverage: 1. Accident-only insurance policies, 2. Tribal or Indian Health Services (IHS), 3. Healthy Montana Kids Plus (HMK Plus) or Medicaid, 4. Mental Health Services Plan (MHSP), 5. School insurance purchased so a child can participate in school-related activities, 6. Children’s Special Health Services (CSHS), and 7. Speciﬁc illness (e.g., cancer) or body parts (e.g., dental or vision) insurance.