468-000-311
A pregnant woman who meets all other eligibility requirements for an ADC grant is eligible to receive a grant beginning with the first day of the month in which the third trimester begins, if the pregnancy has been medically verified. For ADC grant purposes, the unborn child meets the definition of a “dependent child” starting with the final trimester.
If the unborn is subject to the Family Cap (see 468 NAC 2-007.01), once the pregnancy has been medically verified, the unborn is added for Medical Assistance, but the ADC grant will not be increased to account for the needs of the unborn (see exceptions to the family cap at 468 NAC 2-007.01A).
If a woman who is already receiving an ADC grant requests addition of an unborn to her unit, the unborn may be added for Medicaid once the pregnancy is medically verified. If the unborn cannot be added to the ADC grant due to the Family Cap, the client should be notified in writing that the ADC grant cannot be increased. The request date is considered the date of application for an unborn. If the client does not provide verification of the pregnancy within 30 days, the worker shall reject the request for addition of the unborn and send a notice to the client.
Even if the pregnancy verification indicates that the woman is expecting twins or a multiple birth, the ADC grant can only reflect the needs of one unborn child. For Medical Assistance, when the pregnancy verification indicates more than one fetus, the Medical Income Level is increased to reflect the anticipated multiple birth.
Following are some examples related to eligibility of an unborn.
Example 1 Applicant’s only child is an unborn
Example 2 Family Cap
Example 3 Pregnancy not reported
Example 4 Pregnant Minor
Example 5 Adding to Medical Only Case
(Rev. July 17, 2000)