Part of the Medicaid program in every state includes a portion that covers the health care needs of women who are pregnant. In Florida, there are several portions of their Medicaid program that are set up to cover women who are pregnant.
Medicaid is a public, or government run, form of health insurance. It is designed to provide health insurance coverage for people who are low-income and who cannot afford to buy a health plan from a private insurance company. Medicaid is funded, in part, by the federal government. Medicaid is also funded by the government of an individual state.
In Florida, the Medicaid program is administered by the Florida Agency for Health Care Administration. To apply for any of the portions of the Medicaid program, a person must go through the Florida Department of Children and Families.
Women who are pregnant, and who live in Florida, have three different ways to apply for Medicaid coverage. The first is called Presumptive Eligible Pregnant Women (PEPW). It provides temporary coverage for prenatal care, only. Care is provided by local clinics. All pregnant women with family income that is less than or equal to 185% of the federal poverty level may be eligible for coverage.
Another option is the Simplified Eligibility for Pregnant Women (SEPW) program. This one is a simplified “full coverage” program for pregnant women only. It provides full Medicaid coverage for pregnant women. Eligibility is determined for the pregnant woman, only. (The potential eligibility of her other household members is not considered). There is not an asset limit.
All pregnant women who have a family income at or below 185% of the federal poverty level could be eligible. Pregnant women with income above 185% might be enrolled in the Medically Needy program (with a share of cost). Her pregnancy must be verified. Coverage extends through delivery and two post partum months.
There is also an ACCESS application for the “regular” Medicaid program. It is also an application for Medicaid coverage for other family members, for cash assistance, and for food assistance. A woman who is currently covered by the “regular” Medicaid program when she becomes pregnant will have pregnancy services covered by Medicaid.
The Medically Needy program is another potential option. It provides coverage for families, or pregnant women, who would qualify for Medicaid except that their income and/or assets are too high. This program comes with at “share of cost”, which is similar to an insurance deductible.
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