Basic Considerations

For eligibility purposes effective November 1, 2022, pregnancy begins with the month of conception and continues through the 12 th month following the termination of pregnancy. Eligibility terminates at the end of the month in which the 12th month falls. Begin the 12 month count the month after the termination of pregnancy.

Pregnancy termination includes live birth, still birth, spontaneous abortion (miscarriage), therapeutic abortion and elective abortion.

Pregnant Women Medicaid considers a woman as pregnant during the 12-month extended postpartum period. A pregnant woman who is not receiving Medicaid or is not eligible as a pregnant woman prior to and/or including the month of pregnancy termination is not eligible for Pregnant Women Medicaid during the 12-month extended postpartum period even if she meets eligibility requirements during the 12- month period.

A pregnant woman who is correctly determined Medicaid eligible remains financially eligible from the effective month of approval through the end of the 12-month pregnancy transition period, regardless of changes in the BG income. Refer to 2720 Continuous Coverage For Pregnant Women .

A pregnant woman must continue to meet all non-financial eligibility requirements.