Arizona Presumptive Eligibility for Pregnant Women FAQ

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The PE for Pregnant Women program allows Qualified Providers (QPs) to grant immediate, temporary Medicaid coverage for ambulatory prenatal care and prescription drugs for conditions related to pregnancy to low-income, pregnant patients, pending their formal Medicaid application.
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FAQ

During pregnancy, you may access a variety of benefits. These can include medical coverage, prenatal care, and nutritional assistance. Many women are eligible for programs that support maternal health and child development. Explore more about these benefits in the Arizona Presumptive Eligibility for Pregnant Women FAQ.

Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life. Therefore, a decisionally capable pregnant woman's decision to refuse recommended medical or surgical interventions should be respected.

While a medical scheme cannot refuse to accept a pregnant woman who applies for cover, the current pregnancy and childbirth won't be covered.

At least five other states have made moves to reduce eligibility for the program since 2013, but none have ultimately enacted policies that made women ineligible for healthcare during pregnancy. Ohio may be the first.

Medicaid can also deny pregnant women because their household size is too small relative to the total income. Therefore, you do not want to omit a dependent unknowingly or include an extra wage earner and hurt your eligibility.

You and your family can usually get AHCCCS if your family's income is at or below 138% of the Federal Poverty Guidelines (FPG) ($17,774 for an individual in 2022, $36,570 for a family of four).

AHCCCS is designed to cover your regular prenatal & postpartum visits, prenatal blood work, diagnostic ultrasounds, hospital and delivery charges. Services that are not covered: non-diagnostic 3D ultrasounds, non-authorized ultrasounds.

Health coverage if you're pregnant, plan to get pregnant, or recently gave birth. All Health Insurance Marketplace® and Medicaid plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage starts.

All Health Insurance Marketplace® and Medicaid plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage starts. Maternity care and newborn care services provided before and after your child is born are essential health benefits.

To be eligible for Arizona Medicaid, you must be a resident of Arizona, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

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Arizona Presumptive Eligibility for Pregnant Women FAQ