Coverage is available to pregnant women, and women who are within their 60 day post partum period, who are determined ineligible for all Cash, FamilyCare and All Kids Assist programs through case progression. This includes pregnant women ineligible for FamilyCare Assist and All Kids Assist due to failure to meet citizenship/INS status (see PM 03-01-02 and PM 06-05-01).
A baby is automatically eligible for Moms & Babies as a deemed newborn when the mother was eligible for medical coverage at the time of the baby's birth under any of the following medical programs: Moms & Babies, FamilyCare, All Kids Assist, AABD, ACA Adult and Former Foster Care.
The mother can be approved for medical coverage before the baby is born or could be approved retroactively in a backdate request for medical. The newborn is automatically eligible regardless of whether or not the mother's coverage was approved before or after the baby's birth or whether or not the Department was aware that the mother was pregnant.
When the newborn is determined to be automatically eligible due to mother's eligibility for medical, an SSN or signed request for the baby is not required until age 1. Add the baby as soon as you learn of the baby's birth.
Mother Eligible for Family Health Spenddown
A baby born to a pregnant woman who is receiving Family Health Spenddown (met or unmet) at the time of the baby's birth is not automatically eligible. In this situation, determine eligibility for All Kids Share or Premium for the baby. Obtain a signed request for the baby (on the application or a form 243A Request to Add an Additional Household Member) and an SSN or proof of application for an SSN.
Pregnant Women Under Age 19
An application for a pregnant woman under age 19 will progress to Moms & Babies, instead of All Kids Share or Premium (Level 1 or 2), if countable income is over the All Kids Assist level and at or below the Moms & Babies level of 213% of the FPL.
A teen in an active All Kids Share or Premium EDG will progress to Moms & Babies when the worker runs eligibility after a pregnancy is documented if countable income is at or below 213% of the FPL.