Optional Presumptive Eligibility for Pregnant Women (PEPW) Determined by

Optional Presumptive Eligibility for Pregnant Women (PEPW) Determined by Qualified Providers A. Pregnant women may be deemed presumptively eligible by qualified providers for ambulatory prenatal care if, on the basis of preliminary information, the woman qualifies for Medicaid. 1. Presumptive eligibility is a reasonable determination that the family income does not exceed the income limits for pregnant women. 2. At the time of a presumptive eligibility determination, qualified providers shall: a) provide the woman with the application form(s) provided by the Division of Medicaid; b) provide the woman assistance with and/or instructions as to how to complete and file the form; and c) inform the woman to complete a full Medicaid application prior to the end of the temporary presumptive eligibility period. B. A pregnant woman may receive no more than one (1) presumptive eligibility period per pregnancy.