B-9400, Extending Postpartum Coverage After MEPD Termination

Revision 24-4; Effective Dec. 1, 2024

Pregnant or postpartum women who lose eligibility for the following types of assistance automatically transition to Medicaid for Pregnant Women (TP 40) coverage for the remainder of their pregnancy and 12-month postpartum period:

ME - Waivers

ME - State Group Home

ME - Pickle

ME - SSI

ME - State School

ME - Non-State Group Home

ME - State Hospital

ME - Medicaid Buy-In

ME - Medicaid Buy-In for Children (MBIC)

ME - Nursing Facility

ME - Disabled Adult Child

ME - Disabled Widow(er)

ME - Early Aged Widow(er)

Note: ME - Community Attendant is not full Medicaid. Community Attendant Services (CAS) provides payment for attendant care only. Recipients certified on ME - Community Attendant must submit an application to determine eligibility for Pregnant Women (TP 40).

If a pregnant or postpartum woman loses ongoing eligibility for their current Medicaid coverage, a new TP 40 EDG is created without an application for pregnancy Medicaid. A full redetermination of eligibility must occur at the end of the TP 40 certification period.

Continuous Medicaid coverage is provided through the pregnancy and the 12-month postpartum period regardless of any change in circumstance unless the woman:

voluntarily withdraws;

moves out of state;

dies; or

is ineligible due to agency error, fraud, abuse or perjury attributed to the person.