Medicaid Policy
Medicaid Policy
Effective Date: February 1, 2023
No Previous Policy
The age of a member may be a factor for some medical programs when determining eligibility. The member’s age on the first day of the month is applied to the entire month for eligibility. This applies at application as well as for ongoing eligibility. The member must be the required age for eligibility for at least one full day during the month.
Example:
Jane was born on April 1, 2000. Jane applies for benefits on April 1, 2019. When reviewing for eligible programs, Jane would not be eligible for any child programs in the month of application due to age. If Jane requested retroactive medical coverage, she would be considered 18 for any retroactive month.
John was born on June 1, 2000. John has been receiving Child Medicaid benefits since January 2019. John’s Child Medicaid program would close on May 31, 2019. John would need to be looked at for other medical programs for June.