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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 June 2016 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.802 33

M0330.802 NEWBORN CHILDREN UNDER AGE 1

A. Policy 42 CFR 435.301 (b)(1)(iii) - If the state chooses to cover the MN, the State Plan must provide MN coverage to all newborn children born on or after October 1, 1984 to a woman who is eligible as MN and is receiving Medicaid on the date of the child’s birth. Coverage must be provided to those newborn children whose mothers were eligible as MN but whose coverage was restricted to Medicaid payment for labor and delivery as an emergency service. The child remains eligible for one year. B. Nonfinancial Eligibility A child who meets this covered group: • is under age of 1 year; • was born to a mother who is found eligible for Medicaid as medically needy or meets spenddown effective on or before the date of the child’s birth.

If the child’s mother was covered by Medicaid as a medically needy individual in a state other than Virginia at the time of the child’s birth, verification of the mother’s Medicaid coverage must be provided by the parent or authorized representative. 1. Continued Eligibility When Mother Becomes Ineligible Any child born to an eligible pregnant woman will continue to be eligible in this covered group up to age 1. EXAMPLE #4: A pregnant woman applied for Medicaid on October 24, 2008. Her estimated date of conception is March 24, 2008, and her due date is December 20, 2008. Her income exceeds the CN limit for 2 persons. Her resources are within the medically needy resource limit and she is placed on a spenddown for the period October 1, 2008 through March 31, 2009. She meets the spenddown on November 15, 2008, and is enrolled in Medicaid as MN effective November 15, 2008 through March 31, 2009. Her child is born on November 30, 2008, and is enrolled in Medicaid as an MN newborn. The mother’s Medicaid coverage is canceled effective January 31, 2009, the last day of the month in which the 60th day occurred after her pregnancy ended. The newborn’s Medicaid coverage continues through November 30, 2009, the end of the month in which he turns one year old. A renewal of the child’s coverage must be completed for his coverage to continue past age one.

2. Covered Group Eligibility Ends The child no longer meets this covered group effective: a. the end of the month in which the child reaches age 1 year; or b. the end of the month in which the child no longer resides in Virginia.