Page 1049

West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 58 Chapter 10 The Case Maintenance Process

10.9.4 EXTENDED POSTPARTUM An individual who becomes pregnant during the postpartum period is entitled to an extended 12- month postpartum period following the end of the subsequent pregnancy. Example: Daisy is enrolled in Medicaid while pregnant. Her pregnancy ends in May 2022, and a 12-month postpartum coverage period begins. Seven months later, Daisy becomes pregnant again in December 2022, while she is still eligible for and enrolled in coverage. Daisy’s subsequent pregnancy ends in September 2023. A new 12-month extended postpartum period will begin, and Daisy will remain continuously eligible through September 2024. Then Department will conduct a redetermination of eligibility and determine if Daisy remains eligible for Medicaid under the same or another eligibility group. 10.9.5 RETROSPECTIVELY ELIGIBLE A woman who is found retroactively eligible for Medicaid is also eligible for 12-month postpartum. Example: Lily applies on June 15, 2022 and is found eligible for Medicaid. She had given birth on May 15, 2022, which is within the 3-month period prior to the month of the application. The Department determines Lily would have been eligible for Medicaid had she applied in May, and thus is covered retroactively to May. Lily is entitled to extended postpartum coverage from the time of enrollment through the end of the month in which Lily’s12-month postpartum period ends May 31, 2023.

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Page 1049

Official source

West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 58 Chapter 10 The Case Maintenance Process

10.9.4 EXTENDED POSTPARTUM An individual who becomes pregnant during the postpartum period is entitled to an extended 12- month postpartum period following the end of the subsequent pregnancy. Example: Daisy is enrolled in Medicaid while pregnant. Her pregnancy ends in May 2022, and a 12-month postpartum coverage period begins. Seven months later, Daisy becomes pregnant again in December 2022, while she is still eligible for and enrolled in coverage. Daisy’s subsequent pregnancy ends in September 2023. A new 12-month extended postpartum period will begin, and Daisy will remain continuously eligible through September 2024. Then Department will conduct a redetermination of eligibility and determine if Daisy remains eligible for Medicaid under the same or another eligibility group. 10.9.5 RETROSPECTIVELY ELIGIBLE A woman who is found retroactively eligible for Medicaid is also eligible for 12-month postpartum. Example: Lily applies on June 15, 2022 and is found eligible for Medicaid. She had given birth on May 15, 2022, which is within the 3-month period prior to the month of the application. The Department determines Lily would have been eligible for Medicaid had she applied in May, and thus is covered retroactively to May. Lily is entitled to extended postpartum coverage from the time of enrollment through the end of the month in which Lily’s12-month postpartum period ends May 31, 2023.