8.2 Continuously Eligible Newborns

Newborn children are automatically eligible for BC+ from the date of birth through the end of the month in which they turn one year old if:

1. They are under age 13 months.
    

2. The natural mother was determined eligible, in the State of Wisconsin, for one of the following programs.
    

3. 1. BC+ or

   2. Other full-benefit Medicaid (MEH 21.2) or

   3. Emergency Services BC+ or

   4. Emergency Services Medicaid (MEH 31.1) or

   5. BC+ Prenatal Plan (as a non-qualifying immigrant)

Note:  Children born to incarcerated mothers or pregnant minors with family income over 300% of the FPL who were eligible for BC+ are still not eligible as a CEN.

The natural mother’s eligibility could have been determined either prior to the date of delivery or retroactively to cover the date of delivery.

The newborn child does not receive this automatic eligibility if the mother's BC+ enrollment is a temporary enrollment through the Express Enrollment program.

A newborn is no longer required to reside with his/her mother to be eligible as a CEN.  This is true even if the newborn is being placed into foster care, adoption or is residing with a caretaker relative.  A CEN who no longer resides with his/her mother but still resides in Wisconsin should remain eligible as a CEN through the end of the month in which s/he turns one year old.

The child is not required to have an SSN Social Security Number.

The child will be covered under either the Standard or the Benchmark plan, depending on the plan the mother was covered by at the time of the baby’s birth.

Citizenship and identity documentation for a CEN does not have to be obtained until the next review of eligibility after the child turns one year of age.

The CEN will not have to pay premiums and is not subject to the health insurance access/coverage requirements.

This page last updated in Release Number: 09-04

Release Date: 06/18/09

Effective Date: 04/01/09