PM 06-09-05
The following pregnancy information is required to be entered into IES on the Pregnancy Details page:
- Pregnancy Due Date;
- Number of births expected; and
- Pregnancy End Date (when reported).
Note: Pregnancy ends at birth, miscarriage or abortion.
When the pregnant woman asks for medical backdating:
- Countable income cannot be more than the Moms & Babies standard for the earliest backdated month eligibility is being authorized.
- Consider income for the previous months in the following order:
- for the earliest backdated month, up to 3 months, before the application month;
- for the other 2 months if the woman is income ineligible for the earliest month;
- for the application month if the woman is income ineligible for all the backdate months;
- for the month(s) after the application month through the current processing month if the woman is income ineligible for all the backdate months and the application month.
Approve the application month and any backdated months for any months countable income exceeds the standard, as Family Health Spenddown.
Backdating is also available to expectant mothers in the All Kids Assist (PT) and AABD (PT) programs. See PM 03-04-06 for guidance concerning the All Kids Assist (PT) and AABD (PT) programs.
Backdating Examples
Example 1: A pregnant woman with an expected delivery date (EDD) of 11/11/2022, applies for benefits on 07/05/2022 and asks for medical backdating for April, May, and June. She is eligible for Moms & Babies in April. Approve Moms & Babies starting 04/01/2022.
Example 2: A pregnant woman with an EDD of 04/10/2023, applies for benefits on 12/04/2022 and asks for medical backdating for September, October, and November. She is income ineligible for September but income eligible for October. Approve Moms & Babies starting 10/01/2022 and Family Health Spenddown for September.
Example 3: A pregnant woman with an EDD of 04/11/2023, applies for benefits on 12/05/2022 and asks for medical backdating for September, October, and November. She is income ineligible for the backdate months but is income eligible for December. Approve Moms & Babies starting 12/01/2022 and Family Health Spenddown for September through November.
Example 4: A pregnant woman with an EDD of 04/11/2023, applies for benefits on 12/05/2022 and asks for medical backdating for September, October, and November. She is income ineligible for the backdate months and the application month but is income eligible for January. Approve Moms & Babies starting 01/01/2023 and Family Health Spenddown for September through December.
Example 5: A pregnant woman aged 25, with an EDD of 12/25/2023, applies for benefits on 05/10/2023 and ask for medical backdating for February, March, and April. She has income under 138% FPL. She is eligible for ACA in February and March and beginning April (first month of pregnancy) she is eligible for Moms & Babies.
