E410 Pregnancy and Postpartum Examples

Examples

1) Woman’s statement is questionable for pregnancy

The customer states she is pregnant, but on a previous application said she was on leave from work following tubal ligation surgery to prevent pregnancy.

2) Postpartum example where the customer does not qualify for 12-month postpartum coverage

Customer applies for AHCCCS on 8/16/2022. She had the baby on 4/9/2022. The customer is asked about recent pregnancy to see if she could qualify for prior quarter coverage for May, June and July 2022.

The customer would qualify for the PQ coverage for May and June, but she would not qualify for the 12-month extended postpartum program. The customer was not pregnant during the potential coverage months (May, June, July and ongoing).