Presumptive eligibility begins on the day a qualified provider determines that a woman meets any of the income eligibility levels. Eligibility shall be determined within 45 days.
If the woman files an application for Medicaid by the last day of the month following the month in which the qualified provider made the determination of presumptive eligibility, the presumptive eligibility ends on the day that the State agency makes the determination of Medicaid eligibility based on that application.
If the woman does not file an application for Medicaid by the last day of the month following the month in which the qualified provider made the determination, the presumptive eligibility ends on that last day.
A presumptive application approved in error will be closed by the Department upon discovery of the error.
The Department is not required to notify the woman that her PE case has closed, but the Department is required to send a notice when Medicaid eligibility has been determined.
{01/2014}