PM 06-09-06-a

new textA written application is not required to add a baby born to a woman receiving: Moms & Babies, FamilyCare, All Kids Assist, AABD, ACA Adult or Former Foster Care. The only information needed is the baby's name, birth date, and sex. Add the baby to Moms & Babies as soon as you learn of the birth.

IES determines that a child is a deemed newborn when the worker enters a 'Yes' response to this question on the Newborn-Details screen:

  • "Was the mother receiving Medicaid at the time of the birth? Y/N".
  • Example 1: Child is born 07/03/18. Mom applies for herself and her newborn child on 08/02/18 and she asks for backdate. Income is at or below the Moms & Babies income limit in July. Both Mom and child are eligible for Moms & Babies. Answer the question above 'Yes'.
  • Example 2: Child is born 07/03/18. Mom applies for herself and her newborn child on 08/02/18 and she asks for backdate. Income is above the Moms & Babies income limit in July. Mom and child are NOT eligible for Moms & Babies. The child may be eligible for All Kids Premium but would be required to comply with the SSN policy. The Mom may be considered for Family Health Spenddown. Answer the question above 'No'.
  • Example 3: Child is born 07/03/18. Mom is receiving FamilyCare (there is no EDD on the case for her) in the month of July. The baby is automatically eligible for Moms & Babies even though the Department was not aware of the pregnancy. Add the baby as soon as you learn of the baby's birth; neither an SSN nor signed request is required to add the baby. Answer the question above 'Yes'.
  • Example 4: Child is born 07/03/18. Mom applies for the child but not for herself and she did not receive medical in July. The child is NOT eligible for Moms & Babies. The child may be eligible for All Kids Assist, Share, Premium (1 or 2) - but must comply with SSN requirements. Answer the question above 'No'.
  • Example 5: Child is born 07/03/18. Mom is under age 19 and is receiving Premium Level 1 in the month of July. Countable income is under 213% of the FPL. On 08/02/18 the head of household reports the birth and requests medical benefits for the newborn. The worker enters the new information into IES and reruns eligibility. The teen mom is eligible for Moms & Babies for the birth month, and through the post-partum period. The baby is automatically eligible for Moms & Babies even though the Department was not aware of the pregnancy prior to the birth. Neither an SSN nor signed request is required to add the baby. Answer the question above 'Yes'.
  • Example 6: Child is born 07/03/18. Mom had an active ACA Adult case with a certification period that ended on 07/31/18. She had not reported her pregnancy and did not cooperate with the REDE. The case was canceled effective 08/01/18. On 08/02/18 the hospital reports the child's birth. The baby is automatically eligible for Moms & Babies even though the Department was not aware of the pregnancy prior to the birth. Neither an SSN nor signed request is required to add the baby. The worker reinstates the case for the deemed newborn and answers the question above 'Yes'. Mom has 90 days to cooperate with the REDE in order for her own coverage to be reinstated effective the month of cancellation.
  • Example 7: Child is born 07/03/18. Mom had an active Moms & Babies case in July. She is incarcerated on 07/30/18 and the baby goes to live with her sister. Set up a case for the baby in the name of Mom's sister. The baby is automatically eligible for Moms & Babies. Neither an SSN nor signed request is required for the deemed newborn until the child turns 1 year old. Answer the question above 'Yes'.

Designated providers who have access to ABE may submit a Record of Birth via the Provider Portal. IES then attempts to add the newborn automatically to the correct active IES case (see PM 18-03-03 for more information).