WAG 06-08-03-e

Adults do not qualify for Prior Coverage.

All Kids Share and Premium Level 1

Prior coverage is available only the first time a child is approved for All Kids Share or Premium Level 1. To receive prior coverage, a family must submit a request to the HFS All Kids Unit within 6 months of the initial date of All Kids Share or Premium Level 1 coverage for the person for whom prior coverage is requested. The HFS All Kids Unit determines eligibility for prior coverage for all All Kids Share and Premium Level 1 cases, even those approved by DHS Family Community Resource Centers.

Prior coverage will not be authorized:

  • For a month in which spenddown is met for the whole month, or
  • If a child previously received All Kids Rebate, or
  • If a child previously received All Kids Share or Premium Level 1, even if they did not receive prior coverage the first time they were approved for All Kids Share or Premium Level 1.

Authorization of prior coverage does not change the 12-month eligibility period that was set up when the case was approved.

revised textIf there is a break in All Kids Share or Premium Level 1 coverage after a family has received prior coverage, and the family is later eligible for All Kids/FamilyCare Premium Levels 1 or 2, the family must pay their first month's premium before receiving Premium Levels 1 or 2.

Prior coverage begins 2 weeks before the date of application and ends the day Share or Premium Level 1 coverage starts. A premium is not charged for the prior coverage period.

Example: The A family applies on July 6th for the first time. The children are determined eligible beginning September 1st. Prior coverage can be authorized for the period June 22nd through August 31st.

revised textPremium Level 2

Prior Coverage is not available to children other than newborns approved for Premium Level 2. Newborns can receive medical benefits to the month of birth under certain circumstances. Refer to PM 06-08-05 for more information.