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VA Pregnant Women - Medicaid Eligibility

Income Limits

Pregnant women whose countable income does not exceed 133% of the Federal Poverty Level (FPL) are eligible for Medicaid coverage. The countable income is the Assistance Unit's gross earned and unearned income minus Family & Child (F&C) Income Exclusions. In determining the size of the assistance unit, the unborn child of a pregnant woman is counted. The assistance unit size, therefore, is always at least two.

The budget unit includes the pregnant woman's spouse who lives with her unless the spouse receives SSI, or she and/or her spouse are Medicaid minors living with her or his parent(s). Other children may be excluded from the assistance unit if they have their own income. For details, see M0520.600 in the Department of Social Services (DSS) Medicaid Eligibility Manual.

If the countable income should increase after a pregnant woman has become eligible, she remains eligible until her pregnancy terminates. (Her infant remains eligible for a year.)

If when applying the pregnant woman's countable family income exceeds 133% of the Federal Poverty Level, the pregnant woman may be eligible as Medically Needy, in which case there will be a spenddown involved.

Resource Limits

There is no resource limit for pregnant women who meet the 133% income limit.

Pregnant women who do not meet the 133% income limit, and who are in the Medically Needy group, must meet the Medically Needy Resource Limits. (See VA Medicaid Resource Limits.)

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VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn from Chapters M03, M06 & M07 of the Department of Social Services (DSS) Medicaid Manual.

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