|
Effective: March 1, 2010 |
|
|
03.20.10ar6 - MinnesotaCare for Auto Newborns (Archive) |
Archived: September 1, 2010 |
Children born to mothers who were enrolled in MinnesotaCare (or Medical Assistance) during the month of birth are given automatic newborn (also referred to as "auto newborn") eligibility. If these children continue to live with the mother in Minnesota, this automatic eligibility continues through the last day of the month in which the child turns one.
Children ages 0-1 whose mothers were not eligible for MinnesotaCare (or Medical Assistance) for the month of birth do not have auto newborn eligibility. See MinnesotaCare for Children Under 21.
Eligibility factors and links to standard program guidelines are provided below.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
MinnesotaCare Major Program and Eligibility Types (MPETs).
Relationship to Other Groups/Bases.
If a newborn's mother applies after the end of her pregnancy or too late in the course of her pregnancy to be determined eligible for any month she was pregnant and requests retroactive Medical Assistance (MA) coverage:
l Determine MA eligibility if you are a county worker whose agency is a MinnesotaCare enrollment site.
l Otherwise, transfer the application to the applicant’s county of residence for an MA eligibility determination.
See MinnesotaCare With Retroactive MA.
Example:
Tina applies for MinnesotaCare in her county of residence on May 28. She is determined eligible on June 7. Her initial premium payment is received on June 20 and enrollment begins July 1. Tina has a baby on June 15, and requests MA to cover the cost of the birth.
Action:
Determine retroactive MA eligibility for the birth month. If Tina is eligible, she may choose to enroll her child in either MinnesotaCare or MA as an auto newborn.
Automatic eligibility begins on the first day of the month of the child’s birth.
Renewals (standard guidelines)
Infants eligible as auto newborns through the month of their first birthday are exempt from all renewal requirements.
l Renewals are not required from auto newborns whose automatic status ends. Continue eligibility until the next scheduled renewal (even if no other household members are eligible).
l Redetermine the newborn’s eligibility for the month after the first birthday. See End of Eligibility in Group below for further information.
Note: If auto newborns are canceled by the system for non-renewal, the agency will receive a report identifying them so their eligibility can be updated. See Renewing Coverage for an Auto Newborn in the MMIS User Manual for more information.
No verifications are required for auto newborns.
Social Security Number (standard guidelines)
Do not require SSNs for children eligible as auto newborns through the month of their first birthday.
Note: See MinnesotaCare for Children Under 21 for guidelines for newly adopted children of any age.
Children eligible as auto newborns are generally U.S. citizens because they were born in the United States, regardless of the mother's citizenship or immigration status.
MA and MinnesotaCare auto newborns are exempt from citizenship and identity documentation requirements. Do not require documentation of citizenship and identity for currently enrolled auto newborns
Do not require citizenship and identity documentation for applicants who were previously eligible as auto newborns.
Residency (standard guidelines)
Follow standard MinnesotaCare guidelines.
There are no insurance barriers for auto newborns. If other insurance exists, notify the Benefit Recovery Section (BRS) so benefits can be coordinated.
Example:
Nora is born on February 2. Her mother, father, and brother are enrolled in MinnesotaCare at the time of her birth. The family loses eligibility at the time of the next scheduled renewal in May because they have insurance.
Action:
Continue Nora's eligibility as an auto newborn through the month of her first birthday as long as she continues to live with her mother. Notify Benefit Recovery if Nora has other health insurance.
Household Composition (standard guidelines)
These children are eligible without regard to household composition, including the all or nothing rule.
See MinnesotaCare Major Program Eligibility Type (MPET) for information on determining an auto newborn's MPET.
Asset Guidelines (standard guidelines)
Exclude the value of assets for all children under age 21.
There is no income test for auto newborns.
Deductions/Disregards (standard guidelines)
Follow standard MinnesotaCare guidelines.
Do not cancel coverage for children under age two for failure to pay premiums. See MinnesotaCare for Children Under 21 for further information.
Covered Services (Prepaid MHCP Manual)
Follow MinnesotaCare for Children Under 21 guidelines.
If a woman is enrolled in a health plan at the time the child is born, add the child to the mother’s health plan effective the first day of the month of birth. If the woman is not enrolled in a health plan when the child is born, see the Prepaid MHCP Manual.
Consider the child to live with the mother through the 60-day postpartum period even if the child remains in the hospital after the woman is discharged.
l If the child leaves the hospital but lives apart from the mother for more than one full calendar month, cancel MinnesotaCare.
l If a foster parent or relative caretaker applies for MinnesotaCare for the child, the child must meet all eligibility criteria.
Example:
Brian is born on March 4 to a woman enrolled in MinnesotaCare. Brian remains in the hospital because of medical problems until April 15, when he is placed in foster care.
Action:
Terminate Brian’s eligibility as an auto newborn effective May 1. He no longer has auto newborn status because he no longer lives with his mother. Redetermine MinnesotaCare or MA for Brian under another eligibility group or basis.
If the mother legally relinquishes control of the child before the child leaves the hospital, consider the child to be out of the mother’s household and terminate MinnesotaCare starting with the first full calendar month for which you can give 10-day notice after papers are signed giving custody and control of the child to an agency or person other than the mother. This could be a pre-adoptive placement or foster home placement of any duration.
l Advise the child’s foster or pre-adoptive family that they may apply for MinnesotaCare for the child unless the child is on MA. The child is no longer eligible as an auto newborn and must meet all eligibility criteria.
l If the child is legally adopted, terminate MinnesotaCare for the first month for which you can give 10-day notice. The adoptive parents must apply for the child as part of their household.
If legal custody and control of the child is later returned to the mother, the child again becomes automatically eligible for MinnesotaCare through the month of the child’s first birthday.
Example:
Brian was born on March 4 to a woman enrolled in MinnesotaCare. He was placed in foster care on April 15. MinnesotaCare was terminated and MA was approved effective May 1. Brian returns to live with his mother on August 10. MA is terminated effective September 1. His mother requests continued MinnesotaCare coverage for him, although she is no longer eligible and is not requesting coverage for herself.
Action:
Approve MinnesotaCare for Brian effective September 1. Do not require a new application even if the last application is more than 11 months old. See Application Not Required.
Automatic eligibility continues through the last day of the month of the child’s first birthday.
l At the end of the auto newborn period:
n If other household members are active, update the child's eligibility using the current case record.
n If the child is the only one who is active, contact the household to see if they want continued coverage for the child and update information on income, insurance, and other eligibility factors.
l Do not require a renewal until the next scheduled renewal for the household (see renewals above).
Children who are no longer eligible for MinnesotaCare after the automatic eligibility period due to income or insurance barriers may be eligible for Medical Assistance (MA); follow your agency's procedures for an MA determination.
Children who are eligible as auto newborns on MA may be eligible as auto newborns on MinnesotaCare if the mother chooses to receive coverage for the child through MinnesotaCare instead of MA at any time between the child’s birth and the month of the child’s first birthday.
Workers who have contact with families during the application process are encouraged to inform families that the Child and Teen Checkups Program (C&TC) is a MinnesotaCare benefit, and that the county C&TC agency will contact them with more information.