Adult Medicaid Manual MA-2170 MEDICAID FAMILY PLANNING WAIVER

Issued 10/1/05 – Change No. 22-05

I. INTRODUCTION AND OVERVIEW

The Family Planning Waiver is a demonstration waiver under Section 1115(a) of the Social Security Act to extend eligibility for family planning services to women age 19 through 55 and men age 19 through 60 with incomes at or below 185% of the federal poverty level. The purpose of the waiver is to establish a system by which women and men can more easily access family planning services to reduce the number of unplanned pregnancies. The name of this waiver program is the “Be Smart” program.

To qualify for Medicaid Family Planning Waiver (FPW), the applicant must not be eligible for coverage in another Medicaid aid program/category. The Income Maintenance Caseworker (IMC) must always evaluate eligibility for other Medicaid coverage prior to exploring eligibility for FPW.

The primary application for FPW is the DMA-5063, Health Check/NC Health Choice Application; however, any application or redetermination form may be used to apply or be evaluated for FPW.