PM 06-08-03-e

revised textA family requests prior coverage by completing Request for Prior Coverage (Form 243KC).

  1. (All Kids Unit) Authorizes prior coverage with a TA 31/TAR 99.
    1. Sends the family Request for Prior Coverage, Notice of Approval (Form 243KCA) if the family is eligible for prior coverage.

      NOTE: A medical card is not issued for the prior coverage period. 

  2. (All Kids Unit) Sends the family Request for Prior Coverage, if the family is ineligible for prior coverage.

Example 1: The Z family applies for the first time on 11/12/10. Eligibility for All Kids Share is authorized effective 01/11. If the family requests prior coverage timely, it will be authorized for 10/29/10 through 12/31/10.

Example 2: The Y family received All Kids Premium Level 1. They did not request prior coverage within 6 months of the date their coverage began.

Their case was canceled due to nonpayment of their premiums. They reapply and are again eligible for All Kids Premium Level 1. They cannot receive prior coverage, since they received All Kids Share or Premium before.

Example 3: The T family applied on 02/13/11 for their 2 children, Alice and Andy, and were determined eligible effective 04/11. On 05/20/11, Mrs. T had a baby, Barbara, whom she wants added to the case.

Whether or not the other children previously received prior coverage, they can receive prior coverage for Barbara within 6 months of the time Barbara's coverage began, since Barbara has not received All Kids Share or Premium before.