WAG 06-08-05

If a family completes the appropriate form to add a child or adult to an existing All Kids/FamilyCare Share or  Premium case, add the person for the current effective month from the day the signed form is received. For All Kids/FamilyCare Premium, the premium will be increased, if appropriate, for the month the person is added unless the person is added for the month following the processing month.

Due to computer cut off dates and the timing of the receipt of requests to add a family member, some families may not be charged a premium for a month prior to the regular roll month.

revised textExample: A Form 243C is received on 09/14/10 to request the addition of a child to an All Kids Premium Level 2 case. The worker adds the child on 09/21/10. The child gets All Kids Premium for 10/10 but is not billed for that month. The family's premium increases in 11/10.

For a person to be added to a Rebate case, a new Rebate form must be completed. Add a person to a Rebate case for the current processing month, when the Rebate form is received.

When adding a child to an active All Kids Share, Premium, or Rebate case, do not do a new eligibility determination unless the family requests one. If the family requests that eligibility be redetermined, ask for verification of current income.

For a child, if income increases and is now above the All Kids Share, Rebate or current Premium Level standard, add the child and do not change the case until renewal.

The first time the child receives All Kids Share or Premium Level 1, unless the child has previously received Rebate, the child can also receive prior coverage for 2 weeks prior to the date the request to add the child is signed. See PM 06-08-03-e for information about prior coverage.

revised textFor All Kids Premium Level 2, prior coverage is not available to children other than newborns. Newborns can receive medical benefits under Premium Level 2 effective with the month of birth if the child was born to parents who are Illinois residents at the time of birth and the signed request is made prior to the first day of the fourth month after the month of birth. Up to a 3 month backdate may be requested by the parents if they are willing to pay the child's premium from the earliest month of the backdate through the current processing month.

revised textExample: An infant is born July 30, 2010. The newborn may be retroactively enrolled if an application is received before November 1, 2010. The parents may choose to start All Kids Premium Level 2 coverage for the newborn July 1, August 1, September 1 or October 1. Premiums will be due for the first and every subsequent month of coverage.

revised textSome newborns qualify for health insurance from the date of birth through 30 days because the newborn's mother was covered on the health insurance. For Premium Level 2, the child may qualify if the insurance ends after birth. If the family requests a medical backdate, the backdate cannot be authorized over a month insurance was active.

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revised textFor an adult, if the income is over the current applicable FamilyCare standard, do not do a new eligibility determination for the children on the existing case. Refer to PM 06-08-03-f for policy regarding FamilyCare Share or Premium backdating when adding an adult to a case.