12-Month Extended Postpartum Coverage

Individuals may be eligible for the 12-Month Extended Postpartum coverage if:

While pregnant were eligible for and received coverage under Medicaid or PCK in Georgia. The 12-month extended postpartum coverage will not be extended to individuals who were not enrolled in Medicaid or PCK in the Georgia at some point during pregnancy.

Applying for Medicaid benefits were pregnant and received Medicaid-covered services in Georgia while pregnant or terminated during a period of retroactive eligibility. No retroactive coverage in PCK.

Pregnant individuals (including Individuals in their postpartum period) should remain eligible through the last day of the month in which the 12-month extended postpartum period ends regardless of any changes in circumstances that may affect eligibility (ex. income, household composition, gaining SSI or aging out). For PCK individuals in their extended postpartum period, this also includes becoming Medicaid eligible or non-payment of premiums. This list is not all inclusive.

If an individual voluntarily requests closure of their PCK case during their extended postpartum period, the individual would not be eligible for the remainder of the 12-month postpartum period if later approved for a Medicaid COA.

EXCEPTIONS:

Individuals who receive Pregnant Women Medicaid as Emergency Medical Assistance (EMA) are not required to meet the citizenship/identity or enumeration requirements. Refer to 2054 Emergency Medical Assistance .

Individuals who receive Pregnant Women Medicaid are not required to cooperate with DCSS and are not required to apply for other benefits.

A pregnant woman can be determined eligible for continuous Medicaid coverage based on Pregnant Women Medicaid eligibility in any of the three months prior to the application month. The pregnant woman must meet all financial and non-financial requirements and must be pregnant in the prior month in which eligibility is being determined.

A pregnant woman is budgeted at minimum as two individuals (the pregnant woman and the unborn child). Increase the BG to include the number of fetuses per client statement. If the pregnant woman is included in any Family Medicaid category, ensure the fetus(es) are counted in the BG for the family according to the tax-filer/non-filer rules.