5330           NEWBORN CHILD ELIGIBILITY

A child born to a woman eligible for and receiving Medicaid or Denali KidCare in the month of delivery is automatically eligible for Denali KidCare without application.  This includes a child born to an alien under the Emergency Treatment for Aliens category.  See Section 5600.   

Eligibility continues until the end of the month in which the child turns one year old.  The newborn's eligibility is not dependent on the continuation of the mother's eligibility.  This period of automatic Denali KidCare eligibility for the newborn continues through the last day of the month of the child's first birthday.

EXCEPTION:

If the child is receiving inpatient services on the date that he or she becomes ineligible for this coverage due to reaching the age of one, Denali KidCare eligibility continues until the end of the inpatient stay.  To be considered an inpatient, the child must be hospitalized or residing in a long-term care facility as approved by the Division of Health Care Services.

A mother is not required to submit an application for Medicaid or Denali KidCare for herself before delivery, but in order to have the birth month covered, the woman must apply within the three-month retroactive period and be determined eligible for the month of birth.

Neither the Citizenship Status Declaration ( CSD Citizenship Status Declaration ) nor enumeration is required for this coverage because all Denali KidCare requirements are considered met by the mother.

The newborn child's medical bills cannot be paid until the newborn has been assigned a Medicaid ID number.  Therefore, it is very important that the birth of the child be verified as soon as possible.  The birth may be verified by a statement (written or oral) from the mother, hospital, doctor, or any other contact the caseworker determines to be a reasonable verification.  Some hospitals will notify district offices of births in order to facilitate their billing process.  Hospital verification of birth is acceptable as long as the caseworker has no reason to doubt the information provided.

When the newborn's eligibility ends, a new application or a request for an addition to an existing case must be filed in order to establish continued Denali KidCare eligibility.

Example 1:

The household consists of a mother, her spouse, and a newborn infant.  The mother received Denali KidCare pregnant woman coverage throughout her pregnancy and was covered on the date of delivery, making her automatically eligible for postpartum coverage and the child automatically eligible for newborn Denali KidCare coverage.  After the postpartum period, the mother is determined ineligible for Family Medicaid.  Denali KidCare newborn eligibility automatically continues until the end of the month in which the child turns one year old.

Example 2:

The household consists of a mother and her 6-month-old child. The mother received Family Medicaid for herself and her child when the child was born but the Family Medicaid case closes due to excess resources.  Since the mother received Medicaid when the child was born, the child remains automatically eligible for newborn Denali KidCare coverage through the month of his or her first birthday.