Deemed Eligibility for Infants Born to Mother Receiving AAP Benefits

Under the AAP program Medi-Cal is included as a part of the benefits. Infants born to mothers who are receiving AAP benefits are eligible for Medi-Cal under the Deemed Eligibility (DE) for Infants program.

Note: This does not apply to infants born to AAP mothers that do not live in Santa Clara County. For more details regarding the Deemed Eligibility for Infant program refer to Medi-Cal Handbook Chapter 29.2.

 

The infants are deemed eligible for Medi-Cal for one year:

  • Without a separate Medi-Cal application,
  • Without requiring a SSN for the infant, and
  • Without considering the infant’s living arrangements or the mother’s eligibility status.

When the FC bureau is notified that a youth receiving AAP benefits has had a baby the FC bureau must complete an Application Registration in CalSAWS for a new case only for the infant and the infant’s mother. The notification can be established through receipt of any of the following which should include the infant’s name and date of birth:

  • A Newborn Referral From (MC 330),
  • A telephone call,
  • A letter,
  • A facsimile,
  • Notification from the adoption Social Worker, or
  • Contact from the adoptive youth or parent(s).

FC Clerical is only required to complete the Application Registration in CalSAWS then forward the case number and the application for Medi-Cal Expedited Enrollment to District Office. The infant cannot be added to an existing AAP case. Once the case is approved in District Office it follows current MC policy.

A redetermination must be completed in the month the DE infant turns one year old. The redetermination process follows the current MC policy and must be completed in district office. The infant redetermination of MC benefits has no effect on the AAP case.
The following process must be followed when an infant is born to a mother receiving AAP benefits:

  1. FC Clerical/ FC EW
    1. Receives notification the AAP youth (mother) has had a baby

      1. Note: When the full name is not available, contact the adoptive parents or adoption SW. 

  2. FC EW
    1. Reviews the application/request forwards to FC Clerical for Application Registration for Medi-Cal only. 
  3. FC Clerical
    1. Completes the Application Registration for Medi-Cal with only the infant and the infant's mother beginning the date the infant was born and forwards the following information to District Office. 
      1. SCD 1374FC
      2. The application (when available)
      3. A copy of the "Inquire On Case Information" window and the new case number
      4. Any aditional information provided by the adoption SW, adoptive parents, and/or your receiving AAP benefits. 
  4. District Office
    1. Receives the application and approves Medi-Cal as outlined in Medical handbook Section 29-2. 

      1. Note: The infant's redetermination of benefits has no effect on the open AAP case. 

 

Note: If the infant becomes a dependent of the court, foster care eligibility rules apply. 

Related Topics

Medi-Cal