(FCRC/All Kids Unit)
- Approve a Moms and Babies eligible pregnant woman through AIS.
- Set a control to change the case status of the woman, or to cancel coverage, for the calendar month after the month the 60-day postpartum period ends.
- End Moms and Babies coverage after the 60-day postpartum period if the woman had a miscarriage or abortion, or signed an adoption agreement.
- Use Form 157 to notify the woman that she is ineligible. Write the following reason on the form:
Your eligibility for medical assistance was based on your pregnancy. You are no longer pregnant and the 60 day extended medical coverage has ended.
- Change the case status to Assist when the woman is eligible for medical assistance after the 60-day postpartum period.
NOTE: A new application for the woman is not needed if the case category changes to 92 or 93.
- Send Notice of Changes During the Enrollment Period or Eligibility Period (Form 2434A) (with Form 458SPA/SPB attached, if needed) to notify the woman of the change to spenddown status.
Special Procedures for Incarcerated Women
Applications for pregnant women incarcerated in IDOC facilities will be handled by the All Kids Unit. The All Kids Unit will determine eligibility in the usual manner and enter code 30 (IDOC facility) in Item 20.
If you discover that a pregnant woman receiving medical benefits has become incarcerated in an IDOC facility and she is the payee for the case, delete all other persons from the case. Set up a new case for the persons deleted in the name of the person
caring for the children. If the incarcerated pregnant woman is not the payee for the case, delete her from the case. Set up a new case for her.
Change the address on the pregnant woman's case to that of the IDOC facility, change the coding in Item 20 to 30, and transfer the case to the All Kids Unit.
If the woman is still incarcerated when the baby is born, cancel her. The woman is not eligible for 60 days postpartum coverage. Set up a medical-only case for the infant in the name of the person who is caring for the infant unless DCFS takes
If DCFS takes guardianship, add the baby to the mother's case and then cancel the case. DCFS is responsible for authorizing coverage for the infant.
An Assist case set up by the All Kids Unit will be transferred to the Family Community Resource Center where the infant lives.