Modified Adjusted Gross Income (MAGI) - Newborn Medical (N10)

Created on: 
Jul 12 2017

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

Who is eligible to receive N10 (MAGI Newborn Medical)?

A child under the age of one is eligible for categorically needy (CN) Newborn Medical assistance when:

  • The child's mother was eligible for and receiving coverage under a medical program at the time of the child's birth; and
  • The child is a Washington state resident.

For more information on N10 medical eligibility, see Apple Health eligibility manual - WAC 182-505-0210 Washington apple health - Eligibility for children.

Can a client receive N10 (MAGI Newborn Medical) coverage while incarcerated? 

When a client is active or approved under some medical coverage groups while incarcerated, they can still be eligible to receive medical assistance in a suspended status. For more information, see Suspended Medical – State Bill (SB 6430).

How long is the N10 (MAGI Newborn Medical) certification period?

The N10 medical program may be certified up to 12 months, through the end of the month of the child’s first birthday.

How long is a newborn covered under their mother’s medical?

Newborns are covered under their mother’s medical Services Card:

  • Through the month in which the 21st day of life occurs if mom was on managed care, or
  • Through the month that includes the baby's 60th day of life if mom was on fee-for-service medical benefits.

For more information on how long a newborn is covered under their mother's medical, see Apple Health eligibility manual - WAC 182-505-0210 Washington apple health - Eligibility for children - Clarifying Information.

What happens when N10 (MAGI Newborn Medical) is AUTO opened?

When the birth of a newborn is reported through Washington Connection and an N10 is AUTO opened:

  • The newborn’s mother is the Head of Household (HOH) on the Assistance Unit (AU) regardless if she is the HOH on her qualifying medical AU.
  • A separate AU is opened for each newborn in the instance of multiple births to the same mother.
  • The certification period ranges from the newborn’s date of birth through the month of the newborn’s first birthday.
  • If different, the mother’s Estimated Due Date (EDD) is changed to match the newborn’s date of birth.

Online Processing

When is N10 (MAGI Newborn Medical) AUTO opened?

N10 may be AUTO opened when the birth of a newborn is reported through the Washington Connection website if all of the following are true:

  • The mother is eligible for Medicaid at the time her baby is born;
    • This includes P99 Assistance Units (AUs) where the AU status is Active (A). If a P99 is in MA Spenddown (M) status, an N10 does not AUTO open.
  • The newborn has been named;
  • The newborn's gender has been identified;
  • A match is made to the mother’s demographics (including her: Social Security Number, Last Name, First Name and date of birth); and,
  • The mother's Estimated Due Date (EDD) is within a 3 month range of the newborn’s date of birth.

Mainframe Processing

When is N10 (MAGI Newborn Medical) AUTO opened?

N10 may be AUTO opened when the birth of a newborn is reported through the Washington Connection website if all of the following are true:

  • The mother is eligible for Medicaid at the time her baby is born;
    • This includes P99 Assistance Units (AUs) where the AU status is [A] - Active. If a P99 is in [M] - MA Spenddown status, an N10 does not AUTO open.
  • The newborn has been named;
  • The newborn's gender has been identified;
  • A match is made to the mother’s demographics (including her: Social Security Number, Last Name, First Name and date of birth); and,
  • The mother's Estimated Due Date (EDD) is within a 3 month range of the newborn’s date of birth.

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.