Pennsylvania 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

Occasionally a person with an immense desire for, or fear of, pregnancy can develop presumptive, even probable, signs of pregnancy. This is known as a false pregnancy (pseudocyesis) and truly shows how the brain can influence physiology (1).

Positive signs of pregnancy are those signs that are definitely confirmed as a pregnancy. They include fetal heart sounds, ultrasound scanning of the fetus, palpation of the entire fetus, palpation of fetal movements, x-ray, and actual delivery of an infant.

How do I apply for emergency Medicaid coverage for childbirth? If you do not have legal status, you must show you are applying for emergency Medicaid. To do this, you should ask the hospital where you gave birth for a discharge summary. You must send in the discharge summary with your application.

Common Signs of Early PregnancyA missed period. For most women, a missed period is often the first sign they've entered the early stages of pregnancy.Frequent urination.Swollen or tender breasts.Fatigue.Nausea, with or without vomiting.Light spotting and cramping.Bloating.Mood swings.More items...

Some pregnancy symptoms can begin a just few days after conception, even before a positive pregnancy test, which may include: Spotting or cramping: According to the American Pregnancy Association (APA), spotting and cramping may occur 6-12 days after sexual intercourse.

Eligible pregnant women are required to enroll in a Medi-Cal managed care health plan unless they opt to remain with their physician in Fee-for-Service throughout their pregnancy and postpartum period. The expansion of coverage will ensure that pregnant women receive all medically necessary services.

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.

Full-scope Medi-Cal is the same complete coverage you have before or after pregnancy. It automatically includes prenatal care, labor and delivery, and other pregnancy-related services.

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.

What Is MCAP and Who Is Eligible for Services? The Medi-Cal Access Program (MCAP) helps pregnant women in middle-income families who can't afford health insurance and have an income that places them out of range for receiving regular Medi-Cal benefits at a low or no cost.

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Pennsylvania Presumptive Eligibility for Pregnant Women FAQ