|
|
|
For the Pregnant Woman group, a woman must be pregnant.
|
Term |
Definition |
|
Pregnant |
A woman expecting the birth of one or more children. |
|
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. |
| 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 postpartum period as it applies to this group. See Pregnancy and Postpartum for examples. |
Accept the woman’s statement that she is pregnant unless there is strong reason to question the statement.
When the statement is questionable, proof of pregnancy from a health care professional is requested. Eligibility staff do not assume that the woman cannot be pregnant. Proof may be written or received over the phone, and must including the following information:
Name of the pregnant woman;
Statement that she is pregnant;
Estimated date of delivery;
Number of babies expected;
For written proof, the date, and the health care professional’s signature;
For proof received over the phone the name and type of health care professional (for example Nurse Practitioner, Physician, Registered Nurse).
|
Program |
Legal Authorities |
|
Pregnant Woman |
42 USC 1396a(a)(10)(A)(i)(III) and (IV); 42 USC 1396a(a)(10)(A)(ii)(IX); 42 USC 1396u-1 42 CFR 435.116 ARS 36-2901(6)(a)(ii) AAC R9-22-1427(C) |