N.M. Admin. Code § 8.291.400.11 - CONTINUOUS ELIGIBILITY FOR CHILDREN (42 CFR 435.926)
A. HSD provides continuous eligibility for
the period specified in Subsection B and C of
8.291.400.11 NMAC for an individual
who is:
(1) under age 19; and
(2) eligible and enrolled for mandatory or
optional coverage under the state plan.
B. The continuous eligibility period is up to
six years for children from birth until turning age six. A child enrolled for
less than 12 months before turning age six is eligible for 12 months of
continuous eligibility. The continuous eligibility period begins on the
effective date of the individual's eligibility or most recent redetermination
or renewal of eligibility.
C. The
continuous eligibility period is 12 months for children age six until turning
age 19. The continuous eligibility period begins on the effective date of the
individual's eligibility or most recent redetermination or renewal of
eligibility.
D. A child's
eligibility may not be terminated during a continuous eligibility period,
regardless of any changes in circumstances, unless:
(1) the child attains the maximum age of
19;
(2) the child or child's
representative requests a voluntary termination of eligibility;
(3) the child ceases to be a resident of New
Mexico;
(4) the agency determines
that eligibility was erroneously granted at the most recent determination,
redetermination or renewal of eligibility because of agency error or fraud,
abuse, or perjury attributed to the child or the child's representative;
or
(5) the child dies.
Notes
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