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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 October 2018 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.801 30

M0330.801 PREGNANT WOMEN

A. Nonfinancial Eligibility 42 CFR 435.301(b)(1)(i)--If the state chooses to cover the medically needy, the State Plan must provide medically needy coverage to all pregnant women during the course of their pregnancy who, except for income and resources, would be eligible for Medicaid as categorically needy. A pregnant woman’s Medicaid eligibility is first determined in the CN pregnant women covered group which has no resource limit and has an income limit that is higher than the medically needy income limit. If a pregnant woman is not eligible as a CN Pregnant Woman because her income is too high, evaluate as FAMIS MOMS. If the individual is not eligible for FAMIS MOMS, then evaluate as MN. She may spenddown to the lower MN income limit IF her resources are within the MN resource limit. A pregnant woman is eligible in this MN covered group if she meets the pregnant woman definition in M0310.119 and meets the nonfinancial requirements in chapter M02. B. Financial Eligibility 1. Assistance Unit The assistance unit policy and procedures in chapter M05 apply to medically needy pregnant women. If the pregnant woman is not institutionalized, consider the resources and income of a pregnant woman’s spouse with whom she lives and, if the pregnant woman is under age 21, the pregnant woman’s parent(s) with whom she lives. If a pregnant woman also applies for other assistance unit members living with her who do not meet an F&C medically needy covered group, separate financial eligibility determinations are done for the unit. One is the F&C medically needy determination for the pregnant woman. The other financial eligibility determination is based on the other individual’s(s) covered group(s).