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This memorandum outlines the revised screening checklist (DSS-4150) for presumptive eligibility for Medicaid for pregnant women, aligning with updated policies and income levels effective July 1,
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How to fill out revised medicaid presumptive eligibility

How to fill out Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)
01
Obtain the Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150) from your local Medicaid office or website.
02
Carefully read the instructions at the top of the checklist to understand the purpose and required information.
03
Begin filling out the applicant's basic information, including name, address, and contact details.
04
Indicate the applicant's date of birth and social security number in the designated sections.
05
Provide information regarding the applicant's pregnancy, including the estimated due date and number of children expected.
06
Assess and document the applicant's household size and income by following the income guidelines provided in the instructions.
07
Check the boxes for any additional eligibility criteria that the applicant meets as outlined in the checklist.
08
Once all relevant information is completed, review the checklist to ensure accuracy and completeness.
09
Sign and date the checklist to certify that all provided information is correct to the best of your knowledge.
10
Submit the completed checklist to the appropriate Medicaid office for processing.
Who needs Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
01
Pregnant women who are applying for Medicaid coverage.
02
Healthcare providers assisting patients in determining eligibility for Medicaid.
03
Social workers or counselors involved in maternal health support services.
04
Local agencies or organizations aiding pregnant women in accessing health services.
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People Also Ask about
Can you be denied insurance for being pregnant?
If you're pregnant when you apply, an insurance plan can't reject you or charge you more because of your pregnancy. Once you're enrolled, your pregnancy and childbirth are covered from the day your plan starts. A time outside the yearly Open Enrollment Period when you can sign up for health insurance.
What does presumptive eligibility card mean?
Presumptive Eligibility (PE) is a Medi-Cal program providing immediate, temporary coverage for prenatal services (except delivery, family planning, and optional abortion procedures) to low-income women. PE will cover the cost of these services while the County is processing a woman's Medi-Cal application.
Can you get insurance if you are already pregnant?
The Affordable Care Act prohibits insurance from declining to cover preexisting conditions. So, while your pregnancy is a preexisting condition, any new insurance you enroll in WILL be legally required to cover your care.
What is presumptive eligibility for LTSS?
Presumptive eligibility allows for HCBS services to start and for providers to be paid while the individual's full application is still being processed. Then Medicaid will cover those costs back to the date of the application.
Do you automatically qualify for Medicaid when pregnant?
This isn't true, being pregnant does NOT automatically qualify you for Medicaid. You still have to meet income guidelines. The income limits are higher for a pregnant woman however if the individual's income is over the limit they still don't qualify. I'm a welfare caseworker.
Can insurance companies deny coverage for pregnancy?
If you're pregnant when you apply, an insurance plan can't reject you or charge you more because of your pregnancy.
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What is Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
The Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150) is a form used to determine the eligibility of pregnant women for Medicaid coverage on a presumptive basis.
Who is required to file Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
Healthcare providers or institutions that provide care to pregnant women are required to file the DSS-4150 to facilitate the presumptive eligibility determination.
How to fill out Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
To fill out the DSS-4150, providers must complete the sections detailing the patient's personal information, income, household size, and any other relevant data as specified in the form instructions.
What is the purpose of Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
The purpose of the DSS-4150 is to streamline the process of providing immediate Medicaid coverage for pregnant women, ensuring they receive necessary prenatal care without delay.
What information must be reported on Revised Medicaid Presumptive Eligibility for Pregnant Women Screening Checklist (DSS-4150)?
The information that must be reported includes the pregnant woman's name, address, income details, family size, and any other relevant demographic or eligibility information as required by the form.
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