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Security Act (the Act) to provide this authority in Medicaid, which is extended to CHIP through a new subparagraph (J) at section 2107(e)(1) of the Act, added by section 9822 of the ARP. When the state elects this option in Medicaid, it must also make the same election in a separate CHIP, as established under subparagraph (C) of section 1902(e)(16), as referenced in section 2107(e)(1)(J) of the Act. The option is currently limited to a 5-year period beginning on April 1, 2022.

The 12-month postpartum period begins on the last day of a beneficiary’s pregnancy and extends through the end of the month in which the 12-month period ends. Similar to the current 60-day postpartum period, under the extended postpartum coverage option, individuals are entitled to the extended postpartum coverage regardless of the reason the pregnancy ends. States that do not elect the extended postpartum coverage option must continue to provide coverage for pregnant individuals in Medicaid through the 60-day postpartum period as currently required.

States that elect to provide the extended postpartum coverage option are encouraged to educate beneficiaries about the availability of continuous extended postpartum coverage, including posting information on the state agency website and collaborating with providers and stakeholders in their state to provide outreach and education about the new option. States may use Medicaid and CHIP administrative matching funds for beneficiary and provider education and outreach. In addition, states are encouraged to update their notices to ensure pregnant individuals and beneficiaries are aware they are eligible for continuous extended postpartum coverage. States are reminded that program information on Medicaid and CHIP must be provided in plain language and in a manner that is accessible to individuals who have limited English proficiency or are living with disabilities, as required at 42 C.F.R. §§ 435.905(b) and 457.110(a).

Eligibility for Extended Postpartum Coverage

In states that elect the 12-month extended postpartum coverage option, beneficiaries who are eligible for and enrolled in Medicaid or CHIP while pregnant, including lawfully residing children and pregnant individuals covered under the state option provided for at sections 1903(v)(4)(A)(i) and 2107(e)(1)(O) of the Act (commonly known as the “CHIPRA 214” option), are eligible for continuous coverage for the duration of the extended postpartum period. Sections 1902(e)(16) and 2107(e)(1)(J) of the Act authorize 12 months of continuous extended postpartum coverage to individuals who “while pregnant” are eligible for and have received coverage under the Medicaid or CHIP state plan or a demonstration project. As a result, states cannot cover under the extended postpartum coverage option individuals who were not enrolled in Medicaid or CHIP in the state at some point during pregnancy. Note that, for Medicaid, the 12 months of extended postpartum coverage under this option applies to individuals who were pregnant and received Medicaid-covered services while pregnant during a period of retroactive eligibility granted under section 1902(a)(34) of the Act and 42 C.F.R. § 435.915(a).

The extended postpartum coverage option under the state plan is available to Medicaid beneficiaries enrolled in the group for pregnant individuals at 42 C.F.R. § 435.116 as well as pregnant individuals enrolled in any other categorically or medically needy eligibility group. States must ensure they are able to provide continuous extended postpartum coverage for The contents of this document do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract. This document is intended only to provide clarity to the public regarding existing requirements under the law.