Or. Admin. R. 410-200-0425 - Specific Requirements; MAGI Pregnant Woman

In addition to eligibility requirements applicable to the MAGI Pregnant Woman program in other rules in chapter 410 division 200, this rule describes specific eligibility requirements for the MAGI Pregnant Woman program.

(1) To be eligible for the MAGI Pregnant Woman program, an individual must be pregnant, or be within the two calendar months following the month in which their pregnancy ended.

(2) To be eligible for the MAGI Pregnant Woman program, an individual must:

(a) Have household income that is at or below 185 percent of the federal poverty level (OAR 410-200-0315); or

(b) Be eligible for protected eligibility according to the policy described in OAR 410-200-0135.

(3) To be eligible for the MAGI Pregnant Woman program, an individual must not be receiving Supplemental Security Income (SSI).

(4) Once a beneficiary is eligible and receiving Medicaid through the MAGI Pregnant Woman program, they are continuously eligible through the two months following the month in which the pregnancy ends (OAR 410-200-0135) unless one or more of the following occur:

(a) The individual dies;

(b) The individual moves out of state;

(c) The individual becomes incarcerated; or

(d) An adult in the EDG requests the medical benefits are closed.

Notes

Or. Admin. R. 410-200-0425

DMAP 54-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; DMAP 4-2014(Temp), f. & cert. ef. 1-15-14 thru 3-30-14; DMAP 20-2014, f. & cert. ef. 3-28-14; DMAP 67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15; DMAP 3-2015, f. & cert. ef. 1/30/2015; DMAP 78-2015(Temp), f. & cert. ef. 12-22-15 thru 6-18-16; DMAP 24-2016, f. & cert. ef. 6/2/2016; DMAP 23-2020, amend filed 05/07/2020, effective 5/8/2020

Statutory/Other Authority: ORS 411.402, 411.404 & 413.042

Statutes/Other Implemented: ORS 411.400, 411.402, 411.404, 411.406, 411.439, 411.443, 413.032, 414.025, 414.231, 414.447 & 414.706