407 Deemed Newborns

 

Policy

The conditions of eligibility for the Deemed Newborn program are:

·        The child’s mother is determined eligible for MA for the day the baby is born; and

·        The child resides in Arizona.

Newborns are automatically approved for benefits when an AHCCCS Complete Care (ACC) plan or ALTCS program contractor informs AHCCCS that a mother eligible for AHCCCS Medical Assistance or ALTCS has given birth.

 

Definitions

 

Term

Definition

Deemed Newborn Program

Deemed Newborn coverage is for children through the month of the child’s 1st birth date. The child must:

·        Be born to a mother eligible for ALTCS, SSI Cash, SSI MAO, Adult, Caretaker Relative, Pregnant Woman, Children or KidsCare; and

·        Live in Arizona. 

 

Service Package

Customers eligible for the Deemed Newborn program receive AHCCCS Medical Services (MA302.1).

 

Enrollment

Customers approved for coverage under Deemed Newborn program are enrolled in AHCCCS Complete Care (ACC) plan.

NOTE     Deemed Newborns are guaranteed a 12 month eligibility period unless the child does not remain an Arizona resident.

 

Customer Costs

There are no premiums or copayments for the Deemed Newborn Program

 

Legal Authority

This requirement applies to the following programs:

Program

Legal Authorities

Deemed Newborns

42 USC 1396a(e)(4)

42 CFR 435.117

AAC R9-22-1429