Medical Assistance for Families with Children and Adults

2.2.2.1.1 Auto Newborn Basis of Eligibility

A child born to a mother who was eligible for Medical Assistance (MA) on the day the child was born, is automatically eligible for MA for one year. This basis is known as “auto newborn.” Auto newborns qualify for MA without regard to  financial and non-financial eligibility factors except state residency (i.e., automatic eligibility) through the end of the month of the child’s first birthday.

Basis of Eligibility

The MA auto newborn basis of eligibility requires the child be:

  • Born to a mother who is eligible for and enrolled in MA or Emergency Medical Assistance (EMA) on the date of the child’s birth

    • Includes children born to women eligible for CHIP-funded MA, EMA, MA for people receiving services from the Center for Victims of Torture (MA-CVT) or any other MA basis.

    • Includes children whose mothers applied for MA or EMA after the birth and were determined eligible retroactively for the  month of the child’s birth.

    • Includes children whose mother was on MA with a spenddown and met the spenddown in their month of birth.

    • Continued eligibility as an auto newborn is not dependent on the mother maintaining MA eligibility.

  • A resident of Minnesota

    • An auto newborn who moves out of the state, but moves back to Minnesota before the last day of the month of their first birthday is eligible again as an auto newborn through the end of the month of their first birthday.

A child born to a mother enrolled in MinnesotaCare does not have an MA basis of eligibility as an auto newborn.

Verification Requirements

Children with an auto newborn basis of eligibility are exempt from providing MA-FCA mandatory verifications while they have the auto newborn basis. The child may be required to provide additional verifications when the auto newborn basis ends, depending on the basis or program for which they are being redetermined.

Citizenship

All auto newborns and individuals previously eligible as auto newborns are exempt from citizenship verification.

Social Security Number (SSN)

An auto newborn is not required to provide a SSN or furnish proof that they have applied for a SSN while eligible under the basis.

When the child’s eligibility is redetermined at the end of the auto newborn basis, standard MA SSN requirements apply.

Income

There is no income test for auto newborns. When eligibility is redetermined for the month following the month of their first birthday, the child is subject to the income limits and guidelines for the basis under which they are being redetermined.

Eligibility Begin Date

The Auto Newborn basis of eligibility begins on the date that the child is born.

Application

A new application is not required to establish auto newborn eligibility. An auto newborn is entitled to MA under this basis even if the birth is reported at a later time. This includes children who were born in previous certification periods to mothers who were eligible for and enrolled in MA in the month of the child’s birth.

Change in Circumstances

Auto newborns are not required to live with their mother after leaving the hospital to maintain eligibility.

  • An auto newborn is continuously eligible for the auto newborn MA basis through the last day of the month of their first birthday.

  • Changes in household composition or household income do not impact an auto newborn’s eligibility.

Auto newborns eligible for Title IV-E foster care/kinship assistance and Title IV-E or non-Title IV-E adoption assistance must be redetermined under the Title IV-E foster care/Kinship Assistance or Title IV-E or non-Title IV-E adoption assistance MA basis of eligibility. See Medical Assistance Northstar Care Title IV-E Foster Care and Kinship Assistance or MA Northstar Adoption Assistance.

Auto newborns determined eligible for non-Title IV-E foster care or kinship assistance must continue MA under the auto newborn basis.

Eligibility End Date

The auto newborn period begins the day the child is born and ends the last day of the month of their first birthday. An auto newborn is continuously eligible for the auto newborn basis of eligibility until the end of the month of their first birthday.

Eligibility for the auto newborn basis can only be ended before the last day of the month of the child’s first birthday in the following circumstances:

  • Voluntary termination

  • Child starts receiving Title IV-E foster care/kinship assistance or Title IV-E or non-Title IV-E adoption assistance and qualifies for MA under a Northstar basis of eligibility

  • No longer a resident of Minnesota (Including when the child's whereabouts are unknown)

  • Death

Post-Eligibility

Renewal

An auto newborn is exempt from renewal requirements through the end of the month of their first birthday.

Cost-Effective Health Insurance

 Parents/caretakers of auto newborns who have access to a cost-effective group plans through their employer must enroll the newborn if allowable by their plan.

Third Party Liability (TPL)

Parents/caretakers are required to provide information regarding access to or enrollment in other third party benefits when reporting the birth of a newborn. An auto newborn’s eligibility is not affected by a parent or relative caretaker’s refusal to provide TPL information.

Legal Citations

Centers for Medicare & Medicaid Services (CMS) State Health Officials letter re: CHIPRA (Aug. 31, 2009), at https://www.medicaid.gov/federal-policy-guidance/downloads/sho-08-31-09b.pdf

Code of Federal Regulations, title 42, section 435.117

Minnesota Statutes, section 256B.055, subdivision 10

Minnesota Statutes, section 256B.057, subdivision 1