PM 06-09-05: Eligibility for Moms and Babies

WAG 06-09-05

Eligibility begins the month income is equal to or below the Moms and Babies income standard and continues through the Revised Textpostpartum period even if there are income changes.

Coverage can be backdated for up to 3 months before the month of application if eligibility exists.


new textWhen the pregnant woman is requesting medical backdating:

Countable income cannot be more than the Moms & Babies Standard for the earliest backdated month eligibility is being authorized.

IES budgets income for the backdate 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; or
  • 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 Moms & Babies starting with the earliest requested backdate month, up to 3 months before the application month, if the customer meets requirements.

  • Do not consider income changes that happen after the approval month through the postpartum period.
  • Approve the application month and any backdated months for any months countable income exceeds the standard, as Family Health Spenddown.

See WAG 06-09-05 for Backdating Examples.

Over Income for Moms and Babies

Pregnant women with income above the Moms and Babies standard for the application month may be approved for Family Health Spenddown.

Example: A pregnant woman applies for benefits on 12/03/2022. The applicant is income ineligible for Moms & Babies for 12/2022 but is income eligible for 01/01/2023. Approve Moms & Babies starting 01/01/2023. Family Health Spenddown for 12/2022.

New Text End.