10 Colo. Code Regs. § 2505-3-430
Current through Register Vol. 47, No. 24, December 25, 2024
Section 10 CCR 2505-3-430 - ENROLLMENT DATE430.1 Eligibility for the Children's Basic Health Plan shall be effective on the latter of: A. The first day of the month of application for Medical Assistance; orB. The first day of the month the person becomes eligible for the Children's Basic Health Plan program.430.2 Upon being enrolled in the Children's Basic Health Plan, continuous eligibility applies to children under the age of 19, who through an eligibility determination, reassessment or redetermination are found eligible for the Children's Basic Health Plan program. The continuous eligibility period may last for up to 12 months and will begin on the month of application or from the authorization date. A. The continuous eligibility period applies without regard to changes in income or other factors that would otherwise cause the child to be ineligible. i) A 14-day no fault period shall begin on the date the child is determined eligible for Medical Assistance. During the 14-day period, updates or corrections may be made to the child's case. Any changes to the child's case made during the 14-day no fault period may impact his or her eligibility for Medical Assistance.B. A child's continuous eligibility period will end effective the earliest possible month, if any of the following occur: ii) Becomes an inmate of a public institutioniii) The child states that she/he has moved out of the household permanentlyiv) Is no longer a Colorado residentv) Is unable to be located based on evidence or reasonable assumptionvi) Requests to be withdrawn from continuous eligibilityvii) Fails to provide documentation during a reasonable opportunity period as specified in section 8.100.3.H.9viii) Fails to provide a reasonable explanation or paper documentation when self-attested income is not reasonably compatible with income information from an electronic data source, by the end of the 90-day reasonable opportunity period. This exception only applies the first-time income is verified following an initial eligibility determination or an annual redetermination.ix) An eligible person shall not be enrolled in other health insurance coverage 430.3. If determined eligible, the enrollment date of a pregnant woman shall be effective as of the first of the month of the date of application or the first day of the month the pregnant woman becomes eligible. The enrollment span shall end on the last day of the month 12 months after the birth of the child or termination of the pregnancy. Once eligibility has been approved, coverage must be provided regardless of changes in the woman's financial circumstances, once the income verification requirements are met.A. A pregnant women's eligibility period will end effective the earliest possible month, if any of the following occur: i) Fails to provide a reasonable explanation or paper documentation when self-attested income is not reasonably compatible with income information from an electronic data source, by the end of the 90-day reasonable opportunity period. This exception only applies the first-time income is verified following an initial eligibility determination or an annual redetermination.430.4 An eligible person's enrollment date in the selected MCO shall be no later than:A. The first of the month following eligibility determination and MCO selection if eligibility is determined before the 17th of the month.B. The first of the second month following eligibility determination and MCO selection if eligibility is determined on or after the 17th of the month.430.5 A child born to a mother who is enrolled in the Children's Basic Health Plan at the time of the child's birth is guaranteed coverage for one year.A. To receive Medical Assistance under the Children's Basic Health Plan, the birth must be reported verbally or in writing to the County Department of Human Services or Eligibility site. Information provided shall include the baby's name, date of birth, and mother's name or Medical Assistance number. A newborn can be reported at any time by any person. Once reported, a newborn meeting the above criteria shall be added to the mother's Medical Assistance case, or his or her own case if the newborn does not reside with the mother, according to timelines defined by the Department. If adopted, the newborn's agent does not need to file an application or provide a Social Security Number or proof of application for a Social Security Number for the newborn.38 CR 11, June 10, 2015, effective 7/1/201540 CR 03, February 10, 2017, effective 3/2/201740 CR 17, September 10, 2017, effective 9/30/201740 CR 19, October 10, 2017, effective 10/30/201741 CR 19, October 10, 2018, effective 10/30/201842 CR 18, October 10, 2019, effective 10/1/201942 CR 23, December 10, 2019, effective 12/30/201943 CR 11, June 10, 2020, effective 5/8/202043 CR 17, September 10, 2020, effective 9/4/202044 CR 01, January 10, 2021, effective 12/11/202044 CR 17, September 10, 2021, effective 8/9/202144 CR 23, December 10, 2021, effective 11/12/202145 CR 03, February 10, 2022, effective 3/10/202245 CR 07, April 10, 2022, effective 3/11/202245 CR 11, June 10, 2022, effective 6/30/202245 CR 15, August 10, 2022, effective 7/8/202245 CR 22, November 25, 2022, effective 10/14/202245 CR 19, October 10, 2022, effective 10/30/202246 CR 06, March 25, 2023, effective 2/10/202346 CR 07, April 10, 2023, effective 4/30/202346 CR 11, June 10, 2023, effective 5/12/202346 CR 19, October 10, 2023, effective 10/30/2023