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MEDICAL SERVICES POLICY MANUAL,SECTION C

C 200AlternativeApplicationProcesses

C-200 Alternative Application Processes

MS Manual 07/01/20 The following eligibility groups do not follow the standard application processes as described in C-100: • Newborn • Autism Waiver • TEFRA • ARChoices Waiver • PACE • DDS Waiver Alternative Community Services • Referral processes for Eligibles Who Lose SSI due to SSA COLA Increases, Disabled Adult Children, and Disabled Widow/Widowers and Disabled Surviving Divorced Spouses The application process for the above eligibility groups are described below.

C-205 Pregnant Woman (PW)Period of Eligibility MS Manual 01/01/23

An individual found eligible may receive PW Medicaid coverage only during the period of pregnancy and through the end of the month in which the sixtieth (60th) day postpartum falls. Postpartum coverage will be provided to women who are Health Care certified at the time of delivery and to women who have a Health Care application pending at the time of birth and are later found eligible for PW coverage. An individual who applies for Pregnant Woman – Full or Medically Needy Medicaid after termination of a pregnancy may be given benefits to the end of the birth month, if eligible, but may not be given postpartum coverage. A pregnant woman who applies after the birth of the child and is found eligible in the birth month for Unborn Child will be given full postpartum coverage. If the pregnant woman has medical bills in the three (3) months prior to the date of application, retroactive eligibility will be determined. There must have been medical bills incurred to give retroactive coverage. The medical bills must be for the PW. Medical bills for other family members will not qualify the PW for retroactive PW coverage.