Health and Recovery Services Administration, Department of Social and Health Services

Medical Eligibility Overview
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Women's Health

The CN medical program for low-income pregnant women has no resource limits and the income limits are based on 185 percent of the Federal Poverty Level (FPL)*. The pregnant woman can be eligible at any time during her pregnancy. Once eligible, the woman continues to be eligible throughout the pregnancy regardless of changes in income and household composition.

To determine the pregnant woman’s family size, count the pregnant woman and add one for each verified unborn child.

EXAMPLE: A woman who verifies she is pregnant with twins is considered to be a three-person family.

Effective April 1, 2009:

NUMBER OF PERSONS INCOME LIMIT – 185% FPL
1 N/A
2 $2,247
3 $2,823
4 $3,400
5 $3,976
6 $4,553
Add $577 for each additional household member

         *Pregnant women with income above 185 percent FPL
             may be eligible for the MN program.
POSTPARTUM EXTENSION: The postpartum extension provides full scope medical coverage for women who receive medical benefits at the time their pregnancy ends. These funds provide continued medical coverage for 60 days after the month in which pregnancy ends (e.g., pregnancy ends June 10, medical benefits continue through August 31).  Women receive this extension regardless of how the pregnancy ends.
FAMILY PLANNING EXTENSION: The state-funded family planning extension provides an additional 10 months of medical coverage for family planning services only. The extension follows the 60 day post-partum coverage for women who received medical benefits for the pregnancy.  Women receive this extension regardless of how the pregnancy ends.
CASH ASSISTANCE FOR PREGNANT WOMEN:   TANF cash benefits are available to pregnant women.  Eligible women receive full scope medical coverage under (CN) Categorically Needy.
NON-CITIZEN PREGNANT WOMEN:  Pregnant women are eligible for their
care under the noncitizen pregnant women's program if they are not eligible for Medicaid due to citizenship or immigration status.  This includes undocumented women.
BREAST & CERVICAL Treatment Medical Coverage: A CNP medical program for women who have been diagnosed with breast or cervical cancer or a related pre-cancerous condition.  To be eligible, a women must be identified as needing treatment through the Department of Health's (DOH's) Washington Breast and Cervical Health Program (WBCHP) and by Breast and Cervical Early Detection program funded by Center for Disease Control (CDC).  Income and resources eligibility is established by DOH screening program.

Uninsured women is eligible if they:

  • Are under age 65;
  • Have been screened by the WBCHP and the CDC-funded program; and
  • Require treatment for breast or cervical cancer; and
  • Do not have other insurance

For more information you can go to the Department of Health Website at http://www.doh.wa.gov/wbchp/default.htm
TAKE CHARGE:  A Family Planning program which covers pre-pregnancy family planning services, and helps participants take charge of their lives before an unintended pregnancy occurs.  Both women and men, whose family income is at or below 200 percent of the Federal Poverty Level (FPL) and who do not have health insurance coverage or whose current health insurance coverage does not include comprehensive family planning benefits may be eligible.

Effective April 1, 2008:

NUMBER OF PERSONS INCOME LIMIT - 200% FPL

1

 $1,805
2 $2,429
3 $3,052
4 $3,675
5 $4,299
6 $4,922

Add $624 for each additional household member

TAKE CHARGE covers:

  • Annual examination;
  • Family planning education and risk reduction counseling;
  • FDA-approved contraceptive methods including; birth control pills, IUDs and emergency contraception;
  • Over the counter contraceptive products such as; condoms, contraceptive creams or foams; and
  • Sterilization procedures.

Services are accessed through local clinics, doctor's offices and pharmacies who are participating in TAKE CHARGE.  For a list of providers by area call the toll-free Family Planning Hot Line at 1-800-770-4334.  Further information can be found on the DSHS web site at:  http://maa.dshs.wa.gov/familyplan.

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Page modified: November 2009       

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