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When a woman becomes pregnant, or is no longer pregnant, the change can affect eligibility and copayments.
When a woman reports that she is pregnant, she may qualify for the Pregnant Woman program. If she qualifies, Pregnant Woman coverage continues through her postpartum period even if her income later increases. Pregnant women do not have to pay copayments.
During the postpartum period, eligibility is reviewed to see if the woman qualifies for any other AHCCCS Medical Assistance (MA) program.
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Term |
Definition |
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Pregnant |
Pregnant means that a woman is expecting the birth of one or more children. |
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60-day Postpartum Period |
A 60-day period starting the day the pregnancy ends. This period applies to a customer who was not enrolled in AHCCCS while pregnant. A customer who is applying for AHCCCS and was pregnant or in their 60-day postpartum period in any of the 3 months before their application month, may be eligible for Prior Quarter Coverage. |
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12-month Postpartum Period |
A 12-month period starting the day the pregnancy ends. This period ends on the last day of the 12th month. Customer must be enrolled in AHCCCS while pregnant to be in the 12-month postpartum period as it applies to this group. See Pregnancy and Postpartum for examples. |
The woman’s statement that she is pregnant is accepted unless there is strong reason to question the statement.
This policy applies only to the Pregnant Woman program.
Unanticipated changes must be reported within 10 calendar days of the date the change occurred.
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Program |
Legal Authorities |
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Pregnant Woman |
42 CFR 435.116 42 CFR 435.916 |