8.2 Continuously Eligible Newborns (CENs)

Newborn children are automatically eligible for BC+ from the date of birth through the end of the month in which they turn one year old if:

They are under age 13 months.
The natural mother was determined eligible, in the State of Wisconsin, for one of the following programs:
1. BC+
2. Other full-benefit Medicaid (MEH 21.2)
3. Emergency Services BC+
4. Emergency Services Medicaid (MEH 31.1)
5. BC+ Prenatal Program (as a non-qualifying immigrant)

Note: Children born to incarcerated mothers will not be eligible as a CEN. In addition, children born to pregnant minors with family income over 300% FPL who were eligible for BC+ are not eligible as CENs. This policy only applies through March 31, 2014 because children will no longer be eligible above 300% FPL as of April 1, 2014. The natural mother’s eligibility could have been determined either prior to the date of delivery or retroactively to cover the date of delivery.

Example: Sasha. gave birth on April 15. On June 15 she applied for BC+. Her eligibility was backdated to March 15. Her infant son is eligible as a CEN from April 15 through April 30 of the following year, the end of the month in which he turns one year old.

The newborn child does not receive this automatic eligibility as a CEN if the mother's BC+ enrollment is a temporary enrollment through the Express Enrollment program.

A newborn is not required to reside with his/her mother to be eligible as a CEN. This is true even if the newborn is being placed into foster care, adoption or is residing with a caretaker relative . A CEN who no longer resides with his/her mother but still resides in Wisconsin should remain eligible as a CEN through the end of the month in which s/he turns one year old.

Through March 31, 2014, the child will be covered under either the Standard or the Benchmark Plan, depending on the plan the mother was covered by at the time of the baby’s birth. Effective April 1, 2014, all infants eligible for BadgerCare Plus as a CEN will be covered under the Standard Plan. If the child is enrolled in BadgerCare Plus on or after February 1, 2014, the child will be covered under the Standard Plan upon enrollment. If the child is covered by the Benchmark plan prior to February 1, 2014, the child will transition to the Standard plan effective April 1, 2014. Anyone who has ever been eligible as a Continuously Eligible Newborn (CEN) under Wisconsin Medicaid or BadgerCare Plus is exempt from the citizenship and identity documentation requirements.

The CEN will not have to pay premiums and is not subject to the health insurance access/coverage requirements.

This page last updated in Release Number: 14-01
Release Date: 02/07/14
Effective Date: 02/01/14