Coverage

(A) In general During the extension period under this subsection— (i) the State plan shall offer to each family medical assistance which (subject to subparagraphs (B) and (C)) is the same amount, duration, and scope as would be made available to the family if it were still receiving aid under the plan approved under part A of subchapter IV; and (ii) the State plan may offer alternative coverage described in subparagraph (D).

(B) Elimination of most non-acute care benefits At a State’s option and notwithstanding any other provision of this subchapter, a State may choose not to provide medical assistance under this subsection with respect to any (or all) of the items and services described in paragraphs (4)(A), (6), (7), (8), (11), (13), (14), (15), (16), (18), (20), and (21) 1 of section 1396d(a) of this title .

(C) State medicaid “wrap-around” option At a State’s option, the State may elect to apply the option described in subsection (a)(4)(B) (relating to “wrap-around” coverage) for families electing medical assistance under this subsection in the same manner as such option applies to families provided extended eligibility for medical assistance under subsection (a).

(D) Alternative assistance At a State’s option, the State may offer families a choice of health care coverage under one or more of the following, instead of the medical assistance otherwise made available under this subsection: (i) Enrollment in family option of employer plan Enrollment of the caretaker relative and dependent children in a family option of the group health plan offered to the caretaker relative. (ii) Enrollment in family option of State employee plan Enrollment of the caretaker relative and dependent children in a family option within the options of the group health plan or plans offered by the State to State employees. (iii) Enrollment in State uninsured plan Enrollment of the caretaker relative and dependent children in a basic State health plan offered by the State to individuals in the State (or areas of the State) otherwise unable to obtain health insurance coverage. (iv) Enrollment in medicaid managed care organization Enrollment of the caretaker relative and dependent children in a medicaid managed care organization (as defined in section 1396b(m)(1)(A) of this title ). If a State elects to offer an option to enroll a family under this subparagraph, the State shall pay any premiums and other costs for such enrollment imposed on the family and may pay deductibles and coinsurance imposed on the family. A State’s payment of premiums for the enrollment of families under this subparagraph (not including any premiums otherwise payable by an employer and less the amount of premiums collected from such families under paragraph (5)) and payment of any deductibles and coinsurance shall be considered, for purposes of section 1396b(a)(1) of this title , to be payments for medical assistance.

(E) Prohibition on cost-sharing for maternity and preventive pediatric care (i) In general If a State offers any alternative option under subparagraph (D) for families, under each such option the State must assure that care described in clause (ii) is available without charge to the families through— (I) payment of any deductibles, coinsurance, and other cost-sharing respecting such care, or (II) providing coverage under the State plan for such care without any cost-sharing, or any combination of such mechanisms. (ii) Care described The care described in this clause consists of— (I) services related to pregnancy (including prenatal, delivery, and post partum services), and (II) ambulatory preventive pediatric care (including ambulatory early and periodic screening, diagnosis, and treatment services under section 1396d(a)(4)(B) of this title ) for each child who meets the age and date of birth requirements to be a qualified child under section 1396d(n)(2) of this title .