§120.400. Twelve Month Eligibility for Persons under Age 19

a)         Coverage under the Department's Medical Assistance Program shall be provided for all eligible persons under 19 years of age for a 12 month period, regardless of any changes in income that may occur during that period, except as provided in subsections (c) and (d) of this Section.  Provisions under this Section are not applicable to persons under age 19 who do not experience any changes in circumstances and continue to meet all medical assistance eligibility requirements.

 

b)         The 12 month period shall begin the later of:

 

1)         the month in which initial eligibility is determined; or

 

2)         the month in which eligibility has most recently been determined.

 

c)         Eligibility shall end when the earliest of the following occurs:

 

1)         the 12 month period ends; or

 

2)         the person attains age 19; or

 

3)         the person is no longer a resident of Illinois; or

 

4)         the person is incarcerated; this provision shall not apply effective January 1, 2012; or

 

5)         the person dies; or

 

6)         the Department determines that, at the time of application, incorrect or inaccurate information was provided that affected the eligibility determination; or

 

7)         the caretaker relative requests termination; or

 

8)         the child is also the caretaker relative of a child receiving benefits under the Public Aid Code and fails to cooperate with the support enforcement for that child as required by 89 Ill. Adm. Code 160.30; or

 

9)         the Department determines that the child was incorrectly determined to be eligible.

 

d)         Twelve month eligibility under this Section shall not apply to any person who:

 

1)         has only been determined to be presumptively eligible; or

 

2)         has a spenddown; or

 

3)         has only been determined eligible for emergency medical assistance under Section 120.310(b)(3).

 

(Source:  Amended at 35 Ill. Reg. 379, effective December 27, 2010)