PRESUMPTIVE ELIGIBILITY FOR PREGNANT WOMEN

Temporary outpatient prenatal services are provided under the Categorically Needy Healthy Beginnings Program to pregnant women determined to be presumptively eligible. Presumptive eligibility is determined by a qualified provider as defined in § 140.2 (relating to definitions) pending a determination of eligibility for MA benefits by the CAO.

1. (1) Presumptive eligibility is based on the following criteria:

   1. (i) An individual is pregnant.
   2. (ii) An individual is determined income eligible by a qualified provider.

   3. (iii) An individual meets the following specific eligibility conditions:

      1. (A) Chapter 147 (relating to residence).
      2. (B) Chapter 149 (relating to citizenship and alienage).
      3. (C) Signing forms. The applicant for presumptive eligibility is required to complete and sign the application forms designated by the Department.
2. (2) Only one period of presumptive eligibility is granted per individual per pregnancy per qualified provider.