PM 18-03-03

  1. Adding Newborns
  2. IES Phase 2 Action When Deemed Newborn Reaches Age 1
  3. Spenddown Cases

Adding Newborns

  1. If the mother is part of the benefit unit at the time of birth, add the newborn right away for medical when notified of the birth. This can be from any source including but not limited to:
    • the mother/father; or
    • the medical provider (including AKAAs, MCOs and hospital vendors); or
    • receipt of Record of Birth (Form 2636); or
    • receipt of Medical Coverage Request for Newborns (Form 2761).
  2. When the newborn is added to the case, a medical card is automatically generated for the newborn. 
  3. revised textIf the client provides a written request to add the newborn update the Newborn Screen in IES immediately to prevent the system from requesting it again at the REDE.
  4. revised textIf the client hasn't completed a Form 243 or ABE request to add the child or the SSN, this information is required at the REDE at age 1 year.

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new textSee WAG 06-09-06-a for information about adding a deemed newborn to Moms & Babies coverage.

IES Phase 2 Action When Deemed Newborn Reaches Age 1

Newborns whose mother was covered for HFS medical benefits for the newborn's birth are deemed eligible and are continuously eligible for medical benefits until they are a year old regardless of changes in income.

Rather than aligning a deemed newborn's certification period with the other medical EDGs on a case, the newborn's cert period will be set to end after they turn 1 year old. Prior to their 1st birthday, IES initiates a REDE to determine continued eligibility under another medical program. The newborn must now meet income and SSN (or application for SSN) criteria and a written request to add the child is required if not yet on file.

  • Note: This special certification period applies to deemed newborns only. When adding other children to the case, including newborns who are not deemed eligible, their certification period will be aligned with other medical EDGs that are active on the case.  

When adding a deemed newborn in IES it is important to indicate on the newborn screen whether a written request was already received. This will prevent IES from requesting another 243C when the child turns a year old.

Spenddown Cases

For inactive spenddown cases, if the spenddown case is in canceled not met status, see WAG 18-03-10 and WAG 18-05-07.