12100
Medicaid Coverage for Pregnant Women
There are
three basic coverage groups for pregnant women, PW-No Grant, PW-Medically
Needy (Exceptional and Spend Down) and SOBRA PW (including
Presumptive Eligibility).
PW No Grant
|
Full range
of Medicaid services |
None if
application made after birth of child. Through end of month in
which 60th day postpartum falls if made while
pregnant. |
At or
below 29% Reduced Standard of Need (Appendix T) |
Not to
exceed $1,000 for the unit |
|
PW
Medically Needy
Exceptional |
Full range
of Medicaid services except Nursing Facility and Personal Care
Services
|
None if
application made after birth. Through end of month in which 60th
day postpartum falls if made while pregnant. |
MNIL for
unit size
(MS 7610) |
MNRL for
unit size
(MS 7500) |
|
PW
Medically Needy
Spend-Down
|
Full range
of Medicaid benefits for Spend-down period except Nursing
Facility and Personal Care Services |
None if
application made after birth. Through end of month in which 60th
day postpartum falls if made while pregnant. |
Above
SOBRA income limit for unit size
(Appendix
F) |
MNRL for
unit size
(MS 7500) |
SOBRA PW
|
Services
related to pregnancy, delivery & postpartum only |
Through
end of month in which the 60th day postpartum falls |
200% FPL
for unit
size (Appendix F) |
MNRL for
unit size
(MS 7500) |
|
SOBRA
Presumptive Eligibility (PE) |
Ambulatory
prenatal care only |
None |
200% FPL
for unit
size
(Appendix
F) |
Not
Applicable |