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This section describes application requirements that are specific to Prior Quarter Coverage.
To qualify for Prior Quarter Coverage of MA, the person must:
· Be pregnant, in the postpartum period, or under age 19;
· Have a medical expense in a Prior Quarter month. The medical expense can be paid or unpaid; and
· Meet all eligibility requirements in the month the medical service occurred.
To qualify for Prior Quarter Coverage of SLMB or QI-1, the person must:
· Be pregnant, in the postpartum period, or under age 19;
· Have received Medicare Part B in a Prior Quarter month; and
· Meet all eligibility requirements in the month in which Medicare Part B was received.
NOTE Prior quarter coverage for QI-1 cannot begin any earlier than January of the current calendar year.
The prior quarter period depends on when the Prior Quarter Coverage is requested. See the following table for details:
If the request for Prior Quarter Coverage… |
Then… |
Is submitted at the same time as the application for Medical Assistance (MA). |
The Prior Quarter Coverage is the three months before the application month. |
Is NOT submitted at the same time as an application for MA AND The MA application is still pending. |
The prior quarter period is the three months before the application month. |
Is NOT submitted at the same time as an application for MA and MSP AND The MA application has already been completed. |
The prior quarter period is the three months before the month the customer’s request is submitted. |
Information about enrollment in AHCCCS fee-for-service for the Prior Quarter Coverage months can be found in MA1103.
Term |
Definition |
Postpartum period |
The period that begins on the date the pregnancy ends, extends 60 days, and then ends on the last day of the month in which the 60-day period ends. |
The standard MA application timeframes apply to Prior Quarter Coverage. Prior Quarter eligibility is determined on a month-by-month basis.
See MA1311 for policy about processing multiple months.
Program |
Legal Authorities |
ALTCS BCCTP SSI-MAO Freedom to Work Child Adult SLMB QI-1 Caretaker Relative Pregnant Women |
42 CFR 435.915 R9-22-101 & 303 |