Family Healthcare (FAMIS) Manual – Table of Contents

0925.020.05 Prior Quarter (MPW)

The claimant must meet all eligibility factors during the prior quarter. If the claimant becomes eligible for assistance sometime during the prior quarter, eligibility for Title XIX begins on the first day of the month in which the claimant became eligible for assistance. The earliest date of MC+ healthcare coverage determined establishes continuous eligibility (refer to Section 0925.025.00.) from that date forward.

The effective dates of prior quarter coverage are no earlier than the first day of the third month prior to the month of application.

EXAMPLE: Ms. Y applies December 10. The doctor’s statement of December 18 states Ms. Y’s estimated due date is March 5. The earliest date of Title XIX coverage possible is September 1, even though Ms. Y became pregnant before September 1.The medical statement must indicate the estimated due date to determine if the claimant will be eligible for the entire prior quarter.

EXAMPLE: Ms. X applies October 4. The doctor’s statement of October 16 states Ms. X’s estimated due date is June 14. Based on the doctor’s statement, the beginning date of pregnancy is September 14. The prior quarter coverage can begin no earlier than September 1.)