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Pregnant
Women, Utah Medicaid Program
The
Pregnant Women's Program is a medical assistance program
for pregnant women whose monthly income is more than the
income limit for the Prenatal
program. Women may pay a spenddown
and receive Medicaid coverage. The woman does not
have to complete Duty of Support and name the father of
the unborn child. The child may qualify for Medicaid
for 60 days after birth and for the first year under the
Postnatal program.
The income standard, after allowable deductions, is based
on a percentage of the financial assistance grant level,
as determined by the Utah State Legislature. Women
who may not qualify should read the NOTE at bottom of page.
Income
Eligibility Standards in Monthly Amounts
(Updated January 2010)
Household Size *Monthly Income
Household Size *Monthly Income
1
. . . . . . . . . . . $ 382
6 . . . . . . . . $
857
2 . . . . . . . . . . . .
$ 468
7 . . . . . . . . $
897
3 . . . . . . . . . . . .
$ 583
8 . . . . . . . . $
938
4 . . . . . . . . . . . .
$ 682
9 . . . . . . . . $
982
5 . . . . . . . . . . . .
$ 777
10 . . . . . . . . $ 1,023
*Deductions
Deduct
$90.00 from the countable earned income of each working
family member, child care expenses, health and accident
premiums. The $30 plus 1/3 of working income disregard may
be allowed only if a client has received a type of family
Medicaid in one of the last four months. Income too
high? See Spenddown below and also the NOTE at bottom
of page.
*SpendDown
Medicaid
applicants whose income exceeds the monthly income standard
may be considered for the Medically Needy program, sometimes
referred to as the Spenddown Program. This program
allows a person who is otherwise eligible either to pay
"excess" monthly income to the state or to accept
responsibility for a portion of their monthly medical bills.
Asset
Limits
1
person - $2,000.00
2 persons - $3,000.00
For each additional person, add $25.00 Assets too
high? See NOTE at bottom of page.
Retroactive
Coverage
Most
Medicaid programs allow an applicant to request coverage
for medical services for up to three months prior to the
month in which the person filed a Medicaid application.
A person who received medical, dental or mental health services
and subsequently qualifies for Medicaid may return to each
provider with a Medicaid Identification Card for the month
in which service was provided. A provider who has already
rendered services may subsequently choose to accept Medicaid
as payment in full or refuse to seek Medicaid payment
because the patient had not been determined eligible for
Medicaid at the time of service. If the provider accepts
Medicaid, Medicaid may pay for the service. If the
provider refuses Medicaid, the patient is responsible for
the charges.
NOTE:
Other programs for Children and Pregnant Women
Baby
Your Baby : Eligible pregnant women can
receive prenatal care prior to establishing eligibility
for Medicaid. For more information, call the Baby
Your Baby Hotline 1-800-826-9662 or l-800-662-9651.
CHIP (Child Health
Insurance Program): Medical program for children
who don't have medical insurance. CHIP's Income limit
is higher than Medicaid's and CHIP does not have an asset
limit. Call toll-free 1-888-222-2542.
Custody
Medical Care Program: Medical program for a
child in the custody of the State, similar to Foster Care.
Maternal
and Child Health Programs, such as Immunzation,
BabyWatch, Pregnancy Riskline, Women,
Infants and Children (WIC) Program
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