Family and Children's Medicaid MA-3240 PREGNANT WOMAN COVERAGE

REVISED 11/01/11– CHANGE NO. 18-11

I. POLICY RULES APPLICABLE TO PREGNANT WOMAN

A. The pregnant woman may choose to be covered under:

1. MPW with services limited to those related to her pregnancy including post partum coverage or for conditions that her doctor believes will complicate the pregnancy; or

2. MAF if she wishes to receive the full scope of services or if she wishes to be combined with another assistance unit.

3. MIC if she is under 19 and meets all other MIC eligibility requirements.

In addition, encourage the pregnant woman to use a Pregnancy Medical Home (PMH). Give her a copy of the DMA-5076/DMA-5076S, PMH handout. Refer to MA-3205, VI.B. Conducting A Face-To-Face Interview, for PMH instructions.

B. The pregnant woman may be eligible even if she is considering releasing her child for adoption.

1. She may be eligible as a caretaker relative of the child through the month in which the release forms are signed. (Release forms cannot be signed until after the baby is born.)

2. She may be eligible while pregnant and through the post partum period even if she has released the child for adoption.

C. The pregnant woman may apply for retroactive pregnant woman coverage after the pregnancy terminates.

D. When any female is determined ineligible for Medicaid in any aid program/category, including Work First, she must be evaluated for eligibility in all other Medicaid aid program/categories before Medicaid can be terminated or denied. One of the categories to be considered is pregnant woman coverage. Refer to MA-3410, Terminations and Deletions for these requirements.

E. Prior to termination of Pregnant Woman Coverage (MAF or MPW), a re-enrollment must be conducted to evaluate the woman for eligibility in all other Medicaid aid program/ categories. Refer to MA-3410, Terminations and Deletions, V.C., and MA-3420, Re-Enrollments.