P4HB Disenrollment

Women who no longer meet the eligibility criteria outlined for the P4HB program will be disenrolled from the P4HB program. These include women who:

If a woman becomes pregnant while enrolled, she may be determined eligible for Medicaid in the pregnant woman eligibility group in accordance with 42 CFR 435.916.

Women who choose to receive a sterilization procedure and complete all necessary follow-up procedures will be disenrolled.

Women receiving IPC services will be disenrolled from the IPC component and enrolled in the family planning-only component after 2 years of participation. Additional deliveries of subsequent VLBW babies will grant an additional two-year enrollment period in the IPC component.

Before disenrollment of any beneficiary eligible, there must be an administrative renewals for all affected beneficiaries in order to determine if they qualify for Medicaid eligibility under a different eligibility category prior to termination, required under 42 C.F.R. 435.916(f)(1).

Move out of the state

Become incarcerated

Become unable to become pregnant

Women who have aged out