1850.040.10 Continuous Eligibility for Pregnant Women – DSS Manuals

IM-105 December 22, 2023

Individuals who have active coverage, with the exception of state funded coverage such as Blind Pension and Uninsured Women’s Health Services, and become pregnant are eligible for continuous coverage at that level of care through the end of their 12 month postpartum period. The individual may request to be moved to a pregnancy level of care but is not required to do so.

Once it is discovered that a participant is pregnant, do not end coverage prior to the end of the 12 month postpartum period unless:

coverage is voluntarily requested to be closed

individual ceases to be a resident of the State of Missouri

agency determines that eligibility was determined incorrectly because of agency error, fraud or abuse

death of the participant

Pregnant Individuals with Active Children’s Health Insurance Program (CHIP)

If the pregnant individual is a CHIP child they will be transitioned to MO HealthNet for Pregnant Women (MPW) or Show-Me Healthy Babies (SMHB) and granted continuous coverage through the end of the 12 month postpartum period. Do not move a CHIP child/SMHB individual to a Non-CHIP level of care during the postpartum period unless they specifically request the change. If a CHIP/SMHB individual in their postpartum period is moved to a Non-CHIP level of care they cannot regain eligibility under postpartum.