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Title 8: Medicaid Page 6 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Pregnant or Postpartum Women and... Revised October 10, 2025 Continuous Eligibility for Pregnant and… Pregnant or Postpartum Women and Deemed Newborns Three conditions for Medicaid eligibility cross all coverage groups:  Once a pregnant woman establishes Medicaid eligibility (except for Medically Needy when a spenddown has not been met), she remains eligible throughout the pregnancy with a few exceptions.  A woman who is eligible and enrolled in Medicaid on the date her pregnancy ends may remain eligible for Medicaid for the 12-month postpartum period with a few exceptions.  A child born to a Medicaid-eligible mother shall receive Medicaid without an application through the child’s first year of life as long as the child remains an Iowa resident. This includes children born to women who are eligible for emergency services. Continuous Eligibility for Pregnant and Postpartum Women Legal reference: 42 CFR 435.170, 441 IAC 75.18(249A) A pregnant woman who was eligible and enrolled in Medicaid while still pregnant remains continuously eligible for Medicaid throughout the pregnancy and postpartum period without regard to changes in circumstances, with a few exceptions. Exceptions to CE during pregnancy and postpartum:  The individual requests voluntary termination  The individual ceases to be a state resident  The agency determines that the eligibility was determined incorrectly at the most recent determination or redetermination of eligibility because of agency error or fraud, abuse, or perjury attributed to the individual  The individual dies Continuous eligibility does not apply if the pregnant woman was only enrolled under Medically Needy with a spenddown that has not been met, under state-only funding, or during a presumptive eligibility (PE) period. The woman must continue to meet all other eligibility requirements during the rest of her pregnancy. (See also Postpartum Eligibility.) NOTE: A woman who is eligible and enrolled in Medicaid while still pregnant whose benefits are limited to emergency services is continuously eligible without regard to changes in income during the pregnancy and/or postpartum period.