W  Pregnancy and Postpartum

 

 

 

Revised 04/18/2023

 

Policy

When a woman becomes pregnant, or is no longer pregnant, the change can affect eligibility and copayments.

When a woman reports that she is pregnant, she may qualify for the Pregnant Woman program.  If she qualifies, Pregnant Woman coverage continues through her post-partum period even if her income later increases.  Pregnant women do not have to pay copayments. 

During the post-partum period, eligibility is reviewed to see if the woman qualifies for any other AHCCCS Medical Assistance (MA) program.

 

Definition

Term

Definition

Pregnant

Pregnant means that a woman is expecting the birth of one or more children.

Postpartum Period

A 12-month period starting the day the pregnancy ends and stops the last day of the month in the 12th month after the pregnancy ends. Customer must be enrolled in AHCCCS while pregnant to be in the postpartum period as it applies to this group.

See Pregnancy and Postpartum for examples.

 

Proof

The woman’s statement that she is pregnant is accepted unless there is strong reason to question the statement.

 

Programs Affected

This policy applies only to the Pregnant Woman program.

 

Timeframes

Unanticipated changes must be reported within 10 calendar days of the date the change occurred.

 

Legal Authority

Program

Legal Authorities

Pregnant Woman

42 CFR 435.116

42 CFR 435.916