[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR435.116]



[Page 115]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 435_ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN 

MARIANA ISLANDS, AND AMERICAN SAMOA--Table of Contents

 

         Subpart B_Mandatory Coverage of the Categorically Needy

 

Sec. 435.116  Qualified pregnant women and children who are not qualified 

family members.



    (a) The agency must provide Medicaid to a pregnant woman whose 

pregnancy has been medically verified and who--

    (1) Would be eligible for an AFDC cash payment (or would be eligible 

for an AFDC cash payment if coverage under the State's AFDC plan 

included an AFDC-unemployed parents program) if her child had been born 

and was living with her in the month of payment;

    (2) Is a member of a family that would be eligible for an AFDC cash 

payment if the State's AFDC plan included an AFDC-unemployed parents 

program; or

    (3) Meets the income and resource requirements of the State's 

approved AFDC plan. In determining whether the woman meets the AFDC 

income and resource requirements, the unborn child or children are 

considered members of the household, and the woman's family is treated 

as though deprivation exists.

    (b) The provisions of paragraphs (a) (1) and (2) of this section are 

effective October 1, 1984. The provisions of paragraph (a)(3) of this 

section are effective July 1, 1986.

    (c) The agency must provide Medicaid to children who meet all of the 

following criteria:

    (1) They are born after September 30, 1983;

    (2) Effective October 1, 1988, they are under age 6 (or if 

designated by the State, any age that exceeds age 6 but does not exceed 

age 8), and effective October 1, 1989, they are under age 7 (or if 

designated by the State, any age that exceeds age 7 but does not exceed 

age 8); and

    (3) They meet the income and resource requirements of the State's 

approved AFDC plan.



[52 FR 43071, Nov. 9, 1987, as amended at 55 FR 48607, Nov. 21, 1990; 58 

FR 48614, Sept. 17, 1993]