B-6600, Continuous Medicaid Coverage

Revision 24-3; Effective Sept. 1, 2024

Children under 19 who are determined eligible for Medicaid at application or redetermination receive 12 months of continuous eligibility.

A child remains continuously eligible for the full 12-month eligibility period through the month they turn 19. The 12-month continuous eligibility period begins on the first day of the eligibility determination month.

Coverage is continuous regardless of changes, unless the child:

turns 19;

moves out of state;

dies;

requests a voluntary withdrawal; or

was not validly enrolled due to: certification in error at application or last redetermination; or Office of Inspector General (OIG) determination that the person fraudulently received Medicaid and coverage should be denied.

A child may transfer to a different type of Medicaid coverage during the 12-month continuous eligibility period if:

the new program provides the same or better benefits; and

the child meets all eligibility criteria for the new program.

Do not transfer a child to a Medicaid program with lesser benefits during the 12-month continuous eligibility period.

Examples: Transfers from Medicaid to Community Attendant Services (CAS) or Medicaid to Medicare Savings Program (MSP) only are not allowed. Transfers from a Home and Community-Based Services (HCBS) waiver program to Nursing Facility Medicaid or other HCBS waiver program are allowed.