Early and regular prenatal care is so important to the birth of a healthy baby. That's why there is a special health insurance program for pregnant women who would not ordinarily be eligible for Medicaid because their household income is too high.  Pregnant women whose household income is below a certain level (see chart below) may enroll in this program, which will cover medical care and hospitalization during pregnancy.  It may also cover health care bills you received up to three months before your enrollment.  There is no cost for this coverage.  The newborn baby may also be eligible for free insurance after he or she is born.  Most women are eligible for this special Medicaid in two ways:


PEPW (Presumptive Eligibility for Pregnant Women)

  • Allows 60 days of Medicaid coverage for women based on a positive pregnancy test and minimal personal and financial information. 
  • Helps women obtain early prenatal care by providing immediate coverage for medical care through the Medicaid program.
  • This coverage is lost if the woman fails to complete the paperwork or because they are not legal residents of the United States.
Simplified Eligibility

A new simplified eligibility process was recently implemented so that pregnant women can get the coverage they need quicker.  This process includes:
  • a single-page application
  • quick processing time
For those who are eligible, this provides coverage for the entire pregnancy and some services for 60 days afterward.

MomCare also provides a Maternity Care Advisor who can help the pregnant woman find a doctor or midwife, link her to additional services, such as the WIC (Women, Infants, and Children) program, and help her in any way that she might need.

The following table shows the eligibility guidelines for this special program for pregnant women.


2014 Poverty Guidelines

 

Persons in Family Household
(Include unborn child)

Poverty Guideline


For families / households with more than 8 persons, add $4,060 for each additional person.
1

$11,670

2

$15,730

3

$19,790

4

$23,850

5

$27,910

6

$31,970

7

$36,030

8

$49,090


*For family units of more than 8 members contact the Medicaid office at (800) 303-2422.



 

Healthy Start Community Coalition of Okaloosa-Walton Counties, Inc.
201 Miracle Strip Parkway SE, Suite C | Fort Walton Beach, FL  32548
(850) 833-9284  |  Fax (850) 833-9484
 hsow@HealthyStartOkaWalton.org 


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