After pregnancy ends, a consumer enrolled in coverage through Maryland Health Connection needs to add the baby to their household and update Mom’s pregnancy status. Adding a newborn, without updating the pregnancy, will not provide the correct eligibility determination for the mother. Should the pregnancy terminate without a newborn, the pregnancy end date also must be updated.
Consumer portal changes
In the consumer portal, if a newborn is added, HBX will navigate to the page that asks if anyone in the household is pregnant or was pregnant within the last 3 months. If the newborn is added within 3 months of birth, select Yes to this question.
Continue through the application until the Individual Details page displays for the member who was recorded as pregnant in a previous application.
Select Add/Edit: If the expected due date and actual delivery date are the same, select Save and proceed. If not, enter the actual delivery date or pregnancy end date and then select Save before proceeding. Note: the Individual Details page will display again to collect responses to race and ethnicity questions (optional).
Worker portal changes
In the worker portal, select Change My Information. Workers should see a pop up that displays whenever there is a pregnant woman in the application to remind the worker to update the pregnancy page before submitting changes.
Select Person Information, navigate to the pregnancy page, verify or change actual delivery or pregnancy end date, and select Save before proceeding. The worker must select Save so that HBX knows that the mother is no longer pregnant. The Save button is what switches the flag from pregnant to no longer pregnant.
Babies born to Medicaid mothers are deemed MCHP eligible until the end of the 13th month after birth. Changes in the household size after the addition of the newborn may continue eligibility in Medicaid for the mother. It also may open a special enrollment period so that she can enroll in a qualified health plan.
About “The Classroom”
“The Classroom” is Maryland Health Connection’s blog for its consumer assistance community, including navigators, authorized brokers, certified application counselors, caseworkers and call center staff. Check here for updates on training, website releases, new tools, and other helpful information as you help get Marylanders covered through the health insurance marketplace.
We encourage you to also subscribe to “The Connection” blog on MarylandHealthConnection.gov, which provides consumer-friendly information and updates. Be sure to follow us on Facebook, Twitter, Instagram and YouTube!
For questions on this topic or to suggest additional topics for The Classroom, email email@example.com.