PM 06-10-03: Eligibility Period

WAG 06-10-03

revised textWhen an MPE application is received, check to see if the woman is in an active case. If she is covered on an active case, return the MPE application to the provider. If she is not in an active case, MPE coverage starts on the MPE application date. If she has a pending application for Cash or All Kids, MPE coverage starts on the date of the pending application. If she has an active case on which she is not covered or can be added to an active case, send her Form 243 (Request for Medical Benefits for Another Family Member) as an application for ongoing benefits.

The length of coverage depends on whether the pregnant woman applies for ongoing benefits by the last day of the month after she was determined eligible for MPE.

If she does apply for ongoing benefits, she receives 90 days of MPE coverage starting on the date of application for ongoing benefits.

If she does not apply for ongoing benefits, MPE coverage runs for the rest of the month of application and all of the following month. The last day of coverage is the last day of the month following the month of the MPE application.

NOTE: revised textA case review is required when the woman is in an active spenddown case. For that reason, a woman in a spenddown case is limited to 15 days of MPE coverage from the MPE application date (see WAG 06-10-11).