Prenatal and Postnatal Programs

The Prenatal Program is a medical assistance program for pregnant women.  It may cover medical care for the entire pregnancy and for 60 days after the birth. Women only need to meet the income guidelines in one month to be eligible for the remainder of the pregnancy plus the 60 day postnatal coverage for both the mother and the baby.  The income limit, after allowable deductions, is 133% of the Federal Poverty Level, which is typically adjusted annually.   The Federal Poverty Level is available on the Internet at http://aspe.hhs.gov/poverty   Women who do not qualify should see NOTE at bottom of page.

The Postnatal Program is a medical assistance program for children from birth to 12 months. The child qualifies for Medicaid coverage if he or she is born to a mother receiving any type of Utah Medicaid assistance. The mother must submit a birth certificate and name any possible insurance coverage for this program to take affect.

Income Eligibility Limit in Monthly Amounts   (Updated January 2010)            

Household Size  *Monthly Income         Household Size    *Monthly Income

1     . . . . . . . . . . .    $ 1201                       5     . . . . . . . . $ 2,859
2     . . . . . . . . . . . .  $ 1615                       6     . . . . . . . . $ 3,273
3    . . . . . . . . . . . .   $ 2,030                      7     . . . . . . . . $ 3,688
4     . . . . . . . . . . . .  $ 2,444                      8     . . . . . . . . $ 4,102
  For each additional person, add $414.

*Deductions

Deduct $90.00 from the countable earned income of each working family member, child care expenses.  Under limited circumstances, a deduction of $30.00 plus 1/3 of working income may be allowed.  Income too high?  See NOTE at bottom of page.

*SpendDown

NOT allowed.   Women whose household income is more than the monthly income limit will be considered for the Pregnant Women's Program which allows a spenddown. 

Asset Limits

$5,000.00 unless high risk. Applicants who have more than $5,000 in assets can still receive coverage by paying a co-payment amount. The co-payment is a small percentage of total countable assets. Assets too high?  See NOTE at bottom of page.

Retroactive Coverage

Most Medicaid programs allow an applicant to request coverage for medical services for up to three months prior to the month in which the person filed a Medicaid application.  A person who received medical, dental or mental health services and subsequently qualifies for Medicaid may return to each provider with a Medicaid Identification Card for the month in which service was provided. A provider who has already rendered services may subsequently choose to accept Medicaid as payment in full or refuse to seek Medicaid payment because the patient had not been determined eligible for Medicaid at the time of service.  If the provider accepts Medicaid, Medicaid may pay for the service.  If the provider refuses Medicaid, the patient is responsible for the charges.

NOTE:  Federally Qualified Health Centers are clinics that offer low-cost medical care.  It does not matter whether the person qualifies for Medicaid or has health insurance.  The cost of care is based on income.  There is a list of health centers in the brochure "Exploring Medicaid".  The brochure comes in two versions depending on where a person lives. One version of Exploring Medicaid is for people living in the Wasatch Front (Salt Lake, Utah,  Davis, Weber, and Morgan Counties).  The other version of Exploring Medicaid is for people who live in other areas of the state. In either version, look for telephone numbers for Federally Qualified Health Centers in the Resource section of the brochure.