Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 4/24/2024
02000 >>> 02500
02480
02500 Other Newborn Issues - Newborn children who are not eligible under the provisions of 2320, shall have their eligibility determined in the following situations:
2501 - When an application is filed for a newborn within 30 days of the date of birth and the newborn is determined eligible for Medicaid or CHIP, coverage will backdate to the date of birth. For coverage requested more than 31 days from the date of birth, a formal prior medical determination would be required, and if CHIP eligible, a Medically Needy spenddown must be offered prior to CHIP approval.
2502 - If a CHIP eligible member has a child, the child is eligible for deemed CHIP coverage effective the date of birth. For coverage to go back to the date of birth the agency must be notified of the birth prior to the last day of the third month following the month of birth. A baby born to a CHIP beneficiary will have a continuous eligibility period matching that of the CHIP parent and be reviewed at that time. A new application and/or review form is not needed to add the newborn to the case. No verification of the birth is needed to add the newborn, and client statement is acceptable. Verification of citizenship and identity is not required to provide initial coverage. Proof of citizenship and identity will be required at the time of the next review. A loss of contact per 7230 will not affect ongoing eligibility. All other individuals already receiving medical coverage will remain enrolled in either CHIP or Medicaid according to the continuous eligibility provisions. If adding the newborn reduces or eliminates the premium, the change is effective the month following the month of birth.
2503 - An eligibility determination is required for all other newborns including newborns that have CHIP siblings. If the newborn is being added to a case with an open medical program, the child shall be added according to 2460.02. If the request for coverage is received within 30 days of the date of birth and the newborn is determined to be CHIP eligible, the child’s effective date of CHIP coverage shall be the date of birth. If adding the newborn to the case reduces or eliminates the premium, the change is effective the month following the month of birth. A spenddown must be offered prior to CHIP approval if the newborn’s request for coverage is received more than 30 days after the date of birth. If there is no current open medical program for the family, a new application is needed.