OAR 410-200-0135
Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals

(1) Assumed Eligibility – A child born to an individual who is eligible for and receiving Medicaid/CHIP benefits at the time of the birth is assumed eligible until the end of the month in which the child turns one year of age, unless:
(a) The child dies;
(b) The child is no longer a resident of Oregon; or
(c) The child’s representative requests a voluntary termination of the child’s eligibility.
(2) Continuous Eligibility for children – When eligibility for a child under age 19 is redetermined and would result in a loss of eligibility for any Medicaid/CHIP program administered by the agency prior to the end of the renewal month, eligibility shall be maintained in the current program through the end of the renewal month, unless the loss of eligibility is due to any of the following:
(a) The child is no longer an Oregon resident;
(b) The child dies;
(c) The child becomes incarcerated;
(d) The child turns age 19;
(e) For children in the CHIP program, receipt of minimum essential coverage;
(f) An adult in the EDG requests the medical benefits are closed;
(g) The child begins receiving Supplemental Security Income (SSI); or
(h) Eligibility renewal or redetermination cannot be completed because requested information is not submitted by the deadline established by the agency.
(3) Protected Eligibility for pregnant individuals – Individuals who are eligible for and receiving Medicaid for any portion of their pregnancy shall remain eligible through the two calendar months following the month in which the pregnancy ends, unless the individual:
(a) Is no longer an Oregon resident;
(b) Becomes incarcerated;
(c) Dies;
(d) Begins receiving SSI; or
(e) Requests a voluntary termination of eligibility, including a request made by an individual authorized to act on the beneficiary’s behalf.

Source: Rule 410-200-0135 — Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-200-0135.

410‑200‑0010
Overview 410‑200‑0015
General Definitions 410‑200‑0100
Coordinated Eligibility and Enrollment Process with the Department of Human Services and the Federally Facilitated Marketplace 410‑200‑0105
Hospital Presumptive Eligibility 410‑200‑0110
Application and Renewal Processing and Timeliness Standards 410‑200‑0111
Authorized Representatives 410‑200‑0115
HSD Medical Programs—Effective Dates 410‑200‑0120
Notices 410‑200‑0125
Acting on Reported Changes 410‑200‑0130
Retroactive Medical 410‑200‑0135
Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals 410‑200‑0140
Eligibility for Inmates 410‑200‑0145
Contested Case Hearing 410‑200‑0146
Final Orders, Dismissals and Withdrawals 410‑200‑0200
Residency Requirements 410‑200‑0205
Concurrent and Duplicate Program Benefits 410‑200‑0210
Requirement to Provide Social Security Number 410‑200‑0215
Citizenship and Non-Citizen Status Requirements 410‑200‑0220
Requirement to Pursue Assets 410‑200‑0225
Assignment of Rights 410‑200‑0230
Verification 410‑200‑0235
Changes That Must Be Reported 410‑200‑0240
Eligibility for Individuals Who Do Not Meet the Citizen and Non-Citizen Status Requirements 410‑200‑0305
Eligibility Determination Group — MAGI Medicaid/CHIP 410‑200‑0310
Eligibility and Budgeting 410‑200‑0315
Standards and Determining Income Eligibility 410‑200‑0400
Specific Requirements 410‑200‑0405
Specific Requirements 410‑200‑0407
Specific Requirements—Former Foster Care Youth Medical Program 410‑200‑0410
Specific Requirements 410‑200‑0415
Specific Requirements 410‑200‑0420
Specific Requirements 410‑200‑0425
Specific Requirements 410‑200‑0435
Specific Requirements 410‑200‑0440
Specific Requirements 410‑200‑0520
COVID-19 Emergency Policies
Last Updated

Jun. 8, 2021

Rule 410-200-0135’s source at or​.us