5104-9 PREGNANT WOMEN CONSIDERATIONS
A pregnant woman with no other children in the home can receive Family Medicaid benefits beginning 90 days before the expected date of delivery of a medically verified pregnancy. The expected date of delivery may change during the course of the pregnancy; benefits based on pregnancy continue so long as the woman remains in her last 90 days of pregnancy.
The pregnant woman must meet all eligibility factors as if her child were already born and living with her. This includes, but is not limited to, the deprivation of the child. The needs, resources, and income of all household members who would be required to be included in the Family Medicaid household must be considered in determining eligibility. If eligibility exists for the entire household then the pregnant woman is eligible. However, if the pregnant woman is 18 or over, and is in her third trimester, she may be the head of her own household, including the unborn child, and not a mandatory filing unit member with parents or siblings she may be living with.
The spouse or man, who claims to be the father of the pregnant woman’s unborn child, is not eligible for Family Medicaid until the baby is born.
In cases where there is an unrelated male household member, the DPA Paternity Statement is used to determine if deprivation does or does not exist.
Pregnancy must be verified by a licensed medical professional such as a MD, PHN , PA , or nurse-midwife. Verification must include an Estimated Date of Delivery ( EDD ). Coverage begins no earlier than 90 days before the expected date of birth.
If a MD, PHN , PA , or certified nurse-midwife is not available in the client’s home community, a village health aide may verify pregnancy in lieu of transporting the client to a certified health professional.
Note:
If not eligible under this section, refer to section
5310 for Pregnant Woman Eligibility under the Denali KidCare program.
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