1. (1) Pregnant women are defined as “women who are pregnant or post-partum, with household income at or below 141% of the Federal Poverty Level (FPL)”. Medicaid coverage under MAGI-related coverage groups is available for pregnant women meeting the requirements listed below:

   1. (a) The household income must be equal to or less than 141% of the current federal poverty level. A standard income disregard of 5% of the federal poverty level is applied if the individual is not eligible for coverage due to excess income.
   2. (b) Self-attestation must be accepted for pregnancy unless there is information that is not reasonably compatible with such attestation.
   3. (c) The individual must be pregnant or post-partum.
   4. (d) The person to be covered must be living in Alabama and must be a United States citizen or meet alienage requirements.
   5. (e) Any private insurance benefits must be assigned to the State.
   6. (f) Application must be made for any other benefits for which the person's family appears eligible.
   7. (g) Changes in income and/or living arrangements must be reported at annual review.
   8. (h) The person to be covered must furnish or apply for a Social Security number.

2. (2) Children age 0 -18 are defined as “infants and children under age 19 with household income at or below 141% of the Federal Poverty Level”.

   1. (a) The household income must be equal to or less than 141% of the current federal poverty level. A standard income disregard of 5% of the federal poverty level is applied if the individual is not eligible for coverage due to excess income.
   2. (b) The child must be 0 – 18 years old.
   3. (c) Children’s eligibility will continue through the month of their 19th birthday.
   4. (d) The child to be covered must be living in Alabama and must be a United States citizen or meet alienage requirements.
   5. (e) Any private insurance benefits must be assigned to the State.
   6. (f) Application must be made for any other benefits for which the person's family appears eligible.
   7. (g) Changes in income and/or living arrangements must be reported at annual review.
   8. (h) The person to be covered must furnish or apply for a Social Security number.

   Medicaid coverage under poverty provisions is available to children age 0 -18 with income at or below 141% of the Federal Poverty Level meeting the requirements listed below:

Author: Denise Banks, Associate Director, Policy and Training, Beneficiary Services Division

Statutory Authority: Section 6401 of P.L. 101-239, Omnibus Budget Reconciliation Act of 1989 (OBRA 89). Section 4601 of P.L. 101-508, Omnibus Budget Reconciliation Act of 1990 (OBRA 90).

History: Emergency rule effective September 1, 1991. Permanent rule effective December 12, 1991. Amended: Filed December 12, 2001; effective January 16, 2002. Amended: Filed June 12, 2002; effective July 17, 2002. Amended: Filed June 11, 2003; effective July 16, 2003. Amended: Filed February 11, 2014; effective March 18, 2014. Amended: Filed September 11, 2018; effective October 26, 2018.