*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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Effective: September 1, 2010 |
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03.20.10 - MinnesotaCare for Auto Newborns |
Archived: June 1, 2016 (Previous Versions) |
Children born to mothers 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 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)
Auto newborns are exempt from all renewal requirements through the month of their first birthday.
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)
Children eligible as auto newborns are not required to apply for or provide a SSN 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. 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. 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.
See MinnesotaCare Major Program Eligibility Type (MPET) for information on determining an auto newborn's MPET.
Asset Guidelines (standard guidelines)
There is no asset limit for auto newborns.
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.
Auto newborns are not required to live with their mother after leaving the hospital in order to maintain automatic eligibility. If the newborn moves in with the father or a relative caretaker who is enrolled in MA or MinnesotaCare, add the newborn to the adult’s case. If the newborn moves in with a caretaker who is not enrolled in MA or MinnesotaCare, use the caretaker’s address as the address for the newborn. Do not require a new application for the newborn.
Example:
Margaret, who is enrolled in MinnesotaCare, gives birth to Aaron on April 9, 2010. In May, Margaret gives temporary custody of Aaron to her friend Carol.
Action:
Add Aaron to Margaret’s case effective April 1, 2010. Remove Aaron from Margaret’s case for the first full month he is out of the household, allowing for a 10-day notice. Ask Carol whether she wants Aaron to remain on MinnesotaCare or to be transferred to MA. Continue Aaron’s auto newborn eligibility through April 2011.
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 open a new case for the child starting with the first full month he or she is out of the household. If a newborn enrolled with automatic MinnesotaCare eligibility is determined eligible for IV-E foster care or IV-E or state-funded adoption assistance, change the newborn’s eligibility from automatic newborn to MA automatic IV-E foster care or IV-E or state-funded adoption assistance.
Example:
Marcie, a MinnesotaCare enrollee, gives birth to a baby girl on December 15, 2009. Legal custody is transferred to the county prior to the baby’s discharge from the hospital on December 17, 2009. The baby is eligible for IV-E foster care.
Action:
Add the baby to Marcie’s case as an auto newborn from December 1 through December 31, 2009. Remove the baby from Marcie’s case effective January 1, 2010, since January is the first full month of placement. Approve MA eligibility for the baby on her own case with a IV-E foster care basis.
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 eligible as auto newborns on MA are also eligible as auto newborns on MinnesotaCare. Alternatively, children eligible as auto newborns on MinnesotaCare are eligible as auto newborns on MA. The mother may choose to receive coverage for the child through either MinnesotaCare or MA 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.