PM 15-07-05: Medical Benefits When a Woman is No Longer Pregnant at Application

WAG 15-07-05.

Medical benefits are available to a woman of any age whose pregnancy has ended, but who would have qualified had the pregnancy continued.

A woman whose pregnancy has ended qualifies for Moms and Babies or Family Health Spenddown if the pregnancy ended in:

  • the month of application; or
  • one of the 3 months prior to the month of application.

Medical benefits cannot be approved for any time earlier than 3 months before the month of application or for any time after the last day of the calendar month in which the 60-day postpartum period ended.

For these cases, the approval period can be from one to 4 months. The approval period begins with the first month of medical eligibility and ends with the last day of the month the pregnancy ended.