MA1313

Check submitted application to see if the customer asked for help paying for medical bills from the last three months.

• If NO, STOP. There is no PQ request.Continue the application as normal.

• If YES, continue to Step 2.

Review the customers requesting PQ coverage. Is anyone requesting PQ under age 19 or female?

• If NO, STOP. There is no potential PQ eligibility. Continue the application as normal.

• If YES, continue to Step 3.

Is anyone requesting PQ Coverage a woman over the age of 18?

• If YES, continue to Step 4.

• If NO, skip to step 8.

Review the Pregnancy Information Page.

Did the customer answer “No” to the questions asking if anyone is pregnant or had a pregnancy end in the past five months?

• If YES, STOP. The customer does not qualify for PQ. Continue the application as normal.

• If NO, continue to Step 5.

If the customer did not answer the pregnancy questions completely or did not answer them at all, a verification factor for missing questions will be generated and included on the RFI.

NOTE     For ALTCS this information should be collected during the financial interview.

Did the customer provide the information needed to complete the Pregnancy Information page?

• If NO, STOP. Deny PQ months for incomplete application/unanswered questions

• If YES, continue to Step 7.

Enter the information provided by the customer on the Pregnancy Information page. Is the customer pregnant or did she have a pregnancy end in the past five months?

• If NO, STOP. Deny PQ coverage. The customer is not under 19, pregnant or postpartum.

• If YES, continue to Step 8.

Enter income for each PQ month and complete all other pages' questions necessary for PQ.

Approve or Deny Prior Quarter months as appropriate.