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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 January 2021 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.400 13

E. Enrollment The Medicaid ACs for children are:

AC Meaning 090 child under age 6; income greater than 109% FPL, but less than or equal to 143% FPL 091 child under age 6; income less than or equal to 109% FPL 092 • child age 6-19; insured or uninsured with income less than or equal to 109% FPL; • child age 6-19; insured with income greater than 109% FPL and less than or equal to 143% FPL 094 child age 6-19; uninsured with income greater than 109% FPL and less than or equal to 143% FPL Do not change the AC when a child’s health insurance is paid for by Medicaid through the HIPP program. M0330.400 PREGNANT WOMEN & NEWBORN CHILDREN

A. Policy The federal Medicaid law requires the Medicaid State Plan to cover categorically needy (CN) pregnant women and newborn children whose family income is within 143% of the federal poverty level (FPL). The law allows the State Plan to cover these pregnant women and newborns regardless of their resources. B. Nonfinancial Eligibility 1. Pregnant Woman 42CFR 435.116- The woman must meet the pregnant woman definition in M0310.124. The pregnant woman must meet all the nonfinancial eligibility requirements in chapter M02. Non-citizen pregnant women who meet the lawfully residing policy in M0220.314 meet the citizenship requirements for full coverage in the pregnant woman group. A pregnant woman who does not meet the lawfully residing policy in M022.314 may be eligible for FAMIS Prenatal Coverage if they apply for coverage no later than the month their child is born. Use Chapter M23 to evaluate the pregnant woman for eligibility under FAMIS Prenatal Coverage