1620.50.00 PREGNANT HOOSIERS - FULL COVERAGE (MED 3)

These categories are identified in IEDSS as MAMA and MAGP. To be eligible for these categories pregnant individuals must have an attestation of pregnancy and have income less than or equal to 208% of the Federal Poverty Level, with the 5% MAGI disregard included if needed to pass.25 There are no resource eligibility requirements for these categories. If a pregnant individual receiving coverage under either of these two categories receives an increase in income which causes their countable income to exceed the standard, they remain eligible for pregnancy-related coverage through the end of the 12 months postpartum period, as explained in Section 1610.50.00.24 The 12-month postpartum period is available to an individual who meets one of the following criteria: • Applies for Medical Assistance while pregnant and is eligible on the date pregnancy ends (by birth or other means). • Applies for Medical Assistance while pregnant and is eligible on the date pregnancy ends (by birth or other means) and/or was both pregnant and financially eligible in the month of application or one of the three retro months prior to the application. • Applies for Medicaid after the child is born (or the pregnancy is terminated by other means) and was both pregnant and financially eligible in the month of application or one of the three retro months prior to the application Month. For a pregnant individual who was eligible and enrolled on the date their pregnancy ends, the agency must provide coverage described through the last day of the month in which the 12-month postpartum period ends. 25 Example 1: • Retro Month 1 – Individual was pregnant but over the income limit for MAGP • Retro Month 2 – individual was pregnant but over the income limit for MAGP • Retro Month 3 – individual was pregnant, and pregnancy ended, and they were under the income limit for MAGP Application month – individual was over the income limit for MAGP. In this case, the individual should be found eligible for retro month 3 and ongoing, as the increase in income should be disregarded until the postpartum period ends. Example 2: • Retro Month 1 – individual was pregnant but over the income limit for MAGP • Retro Month 2 – individual was pregnant but over the income limit for MAGP • Retro Month 3 – individual was pregnant, and pregnancy ended, and they were still over the income limit for MAGP • Application month – individual was under the income limit for MAGP but fails income test for all other categories In this case, the individual is not eligible for coverage, since she was not eligible for any retro month or the month that pregnancy ended, so income cannot be disregarded for their postpartum period. Example 3: • Retro Month 1 – individual was pregnant but over the income limit for MAGP • Retro Month 2 – individual was pregnant and under the income limit for MAGP • Retro Month 3 – individual was pregnant, and pregnancy ended, but they were over the income limit for MAGP • Application month – individual was over the income limit for MAGP In this case, the individual should be found eligible for Retro month 2 and ongoing, as the increase in income should be disregarded until the postpartum period ends.