601.05 Eligibility Groups Covered

PE will only be available to the following eligibility groups: Pregnant Women, Family Planning, Former Foster Care Children to Age 26, Breast and Cervical Cancer Program, Infants and Children under Age 19, and Parents and Caretaker Relatives.

Each eligibility group included in the PE program will follow the eligibility criteria set forth under its corresponding Medicaid program. An applicant cannot receive PE if he is already eligible in a full benefit category. Individuals determined eligible for PE will not: (i) be given a protected period of eligibility, (ii) be enrolled in managed care, (iii) receive special FMAP rates, or (iv) be made eligible for Emergency Services. Individuals determined ineligible for PE will not be given a right to an appeal or a fair hearing.

If an applicant is Medicaid-eligible after a full eligibility determination is completed, and qualifies for a protected period, the applicant’s protected period begins the first day of PE.