Current through March 20, 2024
Paternity cannot be established unless an alleged father has
signed a written and notarized paternity acknowledgment form or a court has
determined him to be the father. Note: Paternity cannot be established for an
unborn
003.01 Medical Assistance for
Individuals 18 or Younger
Children may receive Medicaid if they meet the eligibility
requirements outlined in this material. See Appendix 477-000-012 for the
applicable federal poverty levels.
1.
Newborn child(ren): Newborn child(ren) born to Medicaid eligible pregnant women
are eligible at the time of birth, if the family income equals the applicable
federal poverty level, through the month of the child's first
birthday.
2. Children up to age
one: Children up to the age of one are eligible if the family income equals the
applicable federal poverty level.
3. Children age five or younger: Children age
one through five (through the month of their sixth birthday) are eligible if
the family income equals the applicable federal poverty level.
4. Children ages six and older: Children ages
6 through 18 are eligible if the family income equals the applicable federal
poverty level. Eligibility continues through the month of the child's 19th
birthday.
5. Children's Health
Insurance Program (CHIP): Children age 18 or younger who do not meet income
limits for Medicaid are eligible for CHIP if the family income is at or below
the applicable Federal Poverty Level and are not covered by creditable health
insurance.
6. Minor pregnant women:
Minor pregnant women who do not meet the income limits for children's Medicaid
are eligible under the Pregnant Woman category if the family income equals the
applicable federal poverty level. Ongoing Medicaid eligibility must be reviewed
prior to the end of the 60-day postpartum period.
003.02 Child in an IMD
18-003.02A
Child in an
IMD: If a child who is placed in an IMD is a ward of the
Department or another public agency or if the placement is court-ordered, see
477 NAC
25-001. If the child who is placed in
an IMD is still considered part of the household, the parent(s)' income is
deemed. See Appendix 477-000-017 for calculation procedures.
18-003.02B
Individuals Age 19 and
20: May be found eligible for services under this category if they
are receiving inpatient care in an Institution for Mental Disease (IMD). If an
individual is an inpatient in an IMD when s/he reaches 21 years of age, s/he
may remain eligible for services either until discharge or until s/he reaches
age 22, whichever comes first.
003.03 Children Ineligible Due to MAGI
Methodologies
Children who lose Medicaid or CHIP eligibility (with or
without health insurance) due to the elimination of disregards as a result of
the conversion to MAGI shall have protective Medicaid coverage for one year if
the child had Medicaid as of December 31, 2013, unless the following conditions
are met previously:
1. Attain age
19;
2. Move out of
Nebraska;
3. Request removal from
the program; or
4.
Deceased.
18-003.03A Exceptions to
the protective status:
1. Children who are
inmates of a public institution; or
2. Children who are patients in an
institution for mental disease (IMD).
This protected group expires December 31,
2015.
003.04 Children Receiving CHIP Who Move to
Medicaid Due to the Increased Federal Poverty Levels under the ACA
Children who move from CHIP to Medicaid as a result of
increased Federal Poverty Levels effective January 1, 2014 shall qualify for
CHIP funding for up to one year if the child was CHIP eligible as of December
31, 2013 and continues to meet Medicaid eligibility requirements.
This group expires December 31, 2015.
