1860.000.00 Newborn – Automatic MO HealthNet Eligibility

1860.010.20 Eligibility Dates

IM-84 May 21, 2019

Section 13 CSR 40.2.260, provides that a child born to a woman eligible for and receiving Title XIX on the date her child is born is deemed to have filed an application and been found eligible for MO HealthNet for Newborns.  The child remains eligible from his/her date of birth until the child’s first birthday.

The Affordable Care Act (ACA) dated January 1, 2014 amended section 42 CFR 435.117(b) to not require the mother to remain eligible for or reside in the home of the child, for the child to be or remain eligible through the first year of life.

Factors that can cease Newborn coverage during the first year:

  • The child is no longer a resident of the State of Missouri.
  • The child is unable to locate as defined in MAGI Manual section, 1885.020.00 Returned Mail.
  • Coverage for the child is voluntarily terminated.
  • The child is placed in Alternative Care (AC) with Children’s Division.
  • Death of the child.

Newborn coverage is to be reinstated up to the child’s first birthday without the need of an application or review of household income when:

  • The child’s Missouri residency is re-established,
  • Newborn coverage for the child is requested after it was voluntarily terminated,
  • or the child is no longer in AC with Children’s Division.

NOTE:  Newborn coverage should be re-established up to the child’s first birthday even if s/he is no longer in the same home of the biological mother whom received Title XIX Medicaid at the time of the child’s birth that caused Newborn eligibility for the child.