Section 120.64  MANG(P) Cases

a)         The following subsections apply to MANG(P) clients.  The eligibility period for a MANG(P) client shall begin with:

1)         the first day of the month of application; or

2)         the first day of any month prior to the month of application if the client so desires up to three months prior to the month of application; or

3)         the first day of the month after the month of application; or

4)         the first day of a month a pregnant woman and/or child under age 19 meets the requirements of Sections 120.11 and 120.31.

b)         The pregnant woman shall be eligible to receive medical assistance until 60 days following the last day of pregnancy.  The 60 day medical coverage continues through the last day of the calendar month in which the 60 day period ends.  The 60 day medical coverage period shall be provided for all women determined eligible for medical assistance under Section 120.11(a)(1) of this Section including women who are no longer pregnant at the time of application because the woman gave birth or had a miscarriage or an abortion, and including women who signed an adoption agreement.

c)         Children shall be eligible to receive medical assistance as determined pursuant to Section 120.400.

d)         Covered services received during the entire eligibility period will be paid by the Department (see 89 Ill. Adm. Code 140.3).

e)         A redetermination of eligibility for MANG(P) will be made every 12 months for children under age 19.

f)          The client is responsible to report any changes that occur during the eligibility period which might affect eligibility for MANG(P).  If changes in income or family composition occur which would make the client ineligible for MANG(P), appropriate action shall be taken by the Department, including evaluation of eligibility for other programs or termination of eligibility for medical assistance.  Income changes occurring after a pregnant woman is determined eligible for MANG(P) coverage are not considered through the 60 day postpartum period following the last day of pregnancy.

g)         MANG(P) clients shall be eligible without a spenddown obligation amount.

h)         A review of case eligibility for MANG(C) will be conducted for a pregnant woman during the second month of the 60 day extended medical coverage period.  If eligible, the case shall be transferred by the Department to the appropriate program without interruption in benefit eligibility.  If ineligible, the Department shall notify the client in writing.

i)          A review of case eligibility for TANF MANG(C) will be conducted when a child is determined ineligible for MANG(P).  If the child is eligible for TANF MANG(C), the case shall be transferred by the Department without interruption in benefit eligibility.  If ineligible, written notification shall be provided to the client.

(Source:  Amended at 24 Ill. Reg. 7361, effective May 1, 2000)