WAG 19-02-07

new textResetting Certification Periods at REDE

At redetermination, a new medical certification period usually starts with the first month after the current certification period ends, however it may start earlier when enough information is available to renew medical eligibility without violating continuous eligibility policy for children.

Programs Medical Cert Periods

Medical only

(1 EDG or all medical EDGs due same time)

The new 12 month period starts with first month after the current certification period ends.

Medical & SNAP

(REDE due at same time)

The new 12 month period starts with first month after the current certification period ends.

Medical & SNAP

(Medical REDE due before SNAP REDE)

The new 12 month period starts with first month after the current certification period ends.

Medical & SNAP

(SNAP REDE due before Medical REDE)

Use SNAP data to REDE the medical EDGs and align the cert period with SNAP, unless a child subject to continuous eligibility would move to a higher cost program (such as from All Kids Assist to Share, or All Kids Share to Premium), or would become ineligible.

If aligned, the new 12 month period starts with first month after the current SNAP certification period ends.

Medical only

(multiple Medical EDGs, with different REDE due dates)

When first EDG comes due, use data to REDE all medical EDGs and align the cert periods unless a child subject to continuous eligibility would move to a higher cost program (such as from All Kids Assist to Share, or All Kids Share to Premium), or would become ineligible.

If aligned, the new 12 month period starts with first month after the current certification period ends for the EDG that is due, and for any other medical EDGs that are aligned with the medical EDG that is due.

new textDeemed Newborns and Pregnant Women

Deemed newborns and pregnant women receive a period of continuous eligibility under policy that is separate from the policy regarding continuous eligibility for children under age 19 that is described in PM 18-05-01.

Deemed Newborns

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.

For an example of a deemed newborn who turns a year old during the certification period, see WAG 18-05-01-b.

Pregnant Women

Under the Moms & Babies program, pregnant women are eligible through their 60 day post partum period regardless of income changes (see PM 06-09-05).

  • When an active recipient is reported to be pregnant, IES may reset the last month of her certification period to ensure that benefits do not end prior to the anticipated end of her post partum period.
  • When a person who is pregnant is being added to the case, she may receive a separate certification period to ensure that benefits do not end prior to the anticipated end of her post partum period, rather than aligning her cert period with the other medical EDGs on the case.
  • When a pregnant woman has a certification period that ends after her post partum period, IES will trigger a Batch Action to rerun eligibility when her post partum period ends to determine whether she can continue to receive medical benefits (see PM 19-08-00).

new textAligning Medical Certification Periods on Active Cases

When a person (other than a deemed newborn or pregnant woman) is added for medical benefits to an IES case with existing medical benefits, IES will align the added individuals' certification period with the certification period of the existing medical EDG.

When a new program is added to an active IES case, the system aligns the certification periods in the following order:

Program added Existing Program Result
MSP EDG Active Medical align Medicare Savings Plan (MSP) with existing medical cert period
Medical EDG  Active Medical align new medical EDG with existing medical cert period
Cash EDG   Active Medical align medical EDG with new cash EDG (REDE done)
Medical EDG ) SNAP align medical EDG with existing SNAP EDG (REDE done)
SNAP Medical align medical EDG with new SNAP EDG (REDE done)