Family Healthcare (FAMIS) Manual

0945.040.00 RESTRICTION OF MEDICAID BENEFITS FOR TEMP RECIPIENTS

Healthcare benefits for TEMP recipients are more limited in scope than regular MC+ benefits.  TEMP Medicaid coverage is restricted to services for “ambulatory prenatal care”.  This means that for TEMP recipients, healthcare coverage pays only for services which are related to the pregnancy and provided on an outpatient basis.  For example: In a doctor’s office, clinic, or outpatient hospital setting, including diagnostic testing; or from a pharmacy.  Delivery is not a covered service under the TEMP program.

While the woman must obtain their TEMP determinations from a Qualified Provider once TEMP eligible, they can obtain services from any Medicaid/MC+ provider, subject to the limitations listed above.