PM 17-02-07: Medical Certification Period in IES

All HFS Medical programs other than 'Health Benefits for Persons with Breast or Cervical Cancer (BCC)' and 'Medical Extensions' have a 12 month certification period. See PM 06-20-04 for BCC and PM 18-05-06 for Medical Extension policy. Since deemed newborns have continuous eligibility through age one, they have a certification period of 13 months (from month of birth to month they reach one year old).

Program Certification Period
Medical Extensions
  • 4 months if due to spousal support
  • 12 months if due to earned income with quarterly reports due in the 4th and 7th months
  • 3 months for precancerous condition
  • 6 months for cervical cancer
  • 12 months for breast cancer or recurrent metastasized cancer
Deemed Newborns 13 months
All other Medical 12 months

Under IES Phase 2, the initial 12 month certification period for all other medical programs will be set in the following manner.

All Kids/FamilyCare Assist, Moms & Babies, ACA Adult, AABD, HBWD and VC

Individual is Eligible in Application Month

Eleven months are added to the month of application to determine the 12 month certification period. Backdate months are not part of the initial 12 month period.

  • Example: a family applies on 1/16/17 and is certified for FamilyCare Assist and All Kids Assist medical benefits on 2/10/17. They receive backdated benefits for Oct., Nov., and Dec. 2016. Their initial 12 month certification period is January through December 2017.

Eligibility Starts a Month after the Application Month

The 12 month certification period begins with the first month of eligibility when an individual is not eligible for the month of application, and is eligible beginning with a month after the application month.

  • Example: A family applies on 1/16/17 and is over income for the month of January, but qualifies for FamilyCare Assist and All Kids Assist effective February. Their initial 12 month certification period is February 2017 through January 2018.
  • Removed Text

See PM 19-02-07 regarding resetting medical certification periods in an IES case at REDE and on active cases.