221 PREGNANT WOMEN SR 97-09, 03/97 (FAM-A)

Some pregnant women meet the TANF medical assistance program criteria even though they do not yet have a dependent child who is deprived of the support or care of a parent. If they meet all the eligibility requirements except for the presence of a dependent child who is deprived of parental care and support, these pregnant women may be eligible for one of the following TANF-related medical assistance coverage groups:

Poverty-Level Pregnant Women (PLP).

• The woman must be pregnant.

• At application, countable income must equal or be less than 185% of the federal poverty income guidelines in Chapter 600, Table C TANF Medical Assistance Net Income Limits and Percentages of Poverty Level. After eligibility is determined, changes in income do not affect eligibility.

Qualified Pregnant Women.

• The woman must be pregnant.

• Countable income must exceed the Poverty-Level Pregnant Women limit.

• Determine the spenddown amount for In and Out medical assistance by using the PIL in Chapter 600, Table C TANF Medical Assistance Net Income Limits and Percentages of Poverty Level. This spenddown amount cannot increase unless the spenddown is not met for any month. If the spenddown is not met in one of the coverage months and the income increased in any of the coverage months after the spenddown was determined, calculate a new spenddown amount.

• Compare countable resources to the TANF medically needy resource limit.

Three months of retroactive medical assistance is available to pregnant women applying for assistance if the pregnancy is verified for the retroactive period.