WAC 388-462-0015

Effective March 4, 2005

WAC 388-462-0015 Medical eligibility for pregnant women.

Eligibility requirements for pregnancy medical are described below.  

  1. A pregnant woman is eligible for categorically needy (CN) scope of care if she meets the following requirements:

    1. Citizenship or immigration status (chapter 388-424 WAC); and
    2. Social Security Account Number (chapter 388-474 WAC) [Ed. Note:  This WAC reference is incorrect.  The correct reference is chapter 388-476 WAC]; and 
    3. Is a Washington state resident (chapter 388-468 WAC); and
    4. Has countable income as described in WAC 388-478-0075.
  2. A pregnant woman is considered for medically needy (MN) scope of care if she meets the requirements in subsection (1)(a) through (c) of this section and:

    1. Has countable income that exceeds the standard in subsection (1)(d) of this section; and

    2. Has countable resources that do not exceed the standard in WAC 388-478-0070.

  3. A pregnant woman may be eligible for non-citizen pregnancy medical if she is not eligible for medical described in subsections (1) and (2) of this section due to citizenship, immigrant status, or Social Security Number requirements.

  4. A pregnant woman meeting the eligibility criteria in subsection (3) is eligible for:

    1. CN scope of care when the countable income is at or below the income standard described in subsection (1)(d); or

    2. MN scope of care when:

      1. The countable income exceeds the standard in subsection (1)(d); and

      2. The resources do not exceed the standard described in 388-478-0070.

  5. Consider as income to the pregnant woman the amount that is actually contributed to her by the father of her unborn child when thepregnant woman is not married to the father.

  6. The assignment of child support and medical support rights as described in chapter 388-422 WAC do not apply to pregnant women.

  7. A woman who was eligible for and received medical coverage on the last day of pregnancy is eligible for extended medical benefits for postpartum care for a minimum of sixty days from the end of her pregnancy. This extension continues through the end of the month in which the sixtieth day falls.

  8. A woman who was eligible for medical coverage on the last day of pregnancy is eligible for family planning services for twelve months from the end of the pregnancy even when eligibility for pregnancy was determined after the pregnancy ended.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.