Page 2

Medicaid Eligibility Manual Eligibility Determinations

Issued March 01, 2024 Page 2 of H-1900 Replacing February 27, 2024 Revised/added text indicated by underscore Deleted text indicated by “**”

• **

Note: Continuous eligibility begins in the month of application rather than the first month of eligibility. Refer to H-1810 Retroactive Medical Eligibility for more information.

**

H-1920 TWELVE (12) MONTHS CONTINUOUS ELIGIBILITY FOR EXTENDED POSTPARTUM

At a minimum, Medicaid beneficiaries who are eligible and enrolled on the date their pregnancy ends must be provided coverage through the calendar month in which the sixty (60) day postpartum period ends. Continuous eligibility applies through the end of the 60-day postpartum period regardless of the eligibility group in which the beneficiary is enrolled and is not affected by changes in income that would otherwise result in a loss of eligibility.

Effective April 1, 2022, in accordance with Sections 9812 and 9822 of the American Rescue Plan Act of 2021 (ARP), the postpartum period is being extended to 12 months. Individuals who are eligible for and enrolled in Medicaid or CHIP while pregnant (including during a period of retroactive eligibility) are eligible for extended coverage through the month in which their extended postpartum period ends. The extended postpartum period begins on the last day of the beneficiary’s pregnancy regardless of how the pregnancy ends and extends through the end of the month in which the 12-month postpartum period ends.

Individuals eligible for extended postpartum are provided continuous eligibility through the last day of the month in which the 12-month postpartum period ends. Beneficiary’s receiving extended postpartum coverage remain eligible regardless of changes in circumstances that may affect eligibility such as income, household composition or categorical eligibility (loss of SSI, reaching an age milestone).

The extended postpartum continuous eligibility will end effective the earliest possible month if any of the following changes occur:

• The individual or representative requests voluntary disenrollment