WAG 18-05-01-b: Ensuring Newborn Receives Medical for First 12 Months

PM 18-05-01-b

new textCDB/Legacy System

If a newborn is added to an existing case and the case becomes ineligible before the newborn's first birthday:

  1. Delete the rest of the family from the case.
    1. Set up an All Kids Share revised textor Premium case for any person(s) under 19 (other than the newborn) who qualifies.
  2. Update Item 30 to the month of the newborn's birth.

Example: Ms. B receives Moms and Babies for herself. The LMDD is 02/01. Her baby is born on 05/06/01 and added to the case. Ms. B fails to respond to the worker's request for proof of current income at the end of the 60-day postpartum period. Delete Ms. B from the case and enter 05/01 in Item 30.

deleted text

new textDeemed Newborns (IES Phase 2)

new textNewborns 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.

  • Example: Ms. G receives FamilyCare for herself and All Kids Assist for her 5 year old son, Carl. The certification periods for the FamilyCare and Assist EDGs are Jan through Dec 2017. In April 2017 she reports that she had a baby, Judith, born April 5th. Judith is added for medical benefits effective April 2017. The last month of Judith's cert period will be April 2018.
  • When Ms. G and Carl are REDE'd the following December, an income increase is reported. Ms. G is canceled due to being over income, Carl goes to All Kids Share, and Judith continues as a deemed newborn for the remainder of her certification period.