Presumptive Eligibility for Pregnant Women (PE), which began
July 1, 2009, provides coverage to women while the women's Hoosier
Healthwise applications are under review by the Division of Family
Women found to be presumptively eligible have coverage for
ambulatory prenatal services while their applications and the
determination process for Hoosier Healthwise/Medicaid is completed.
Providers are reimbursed for covered services provided during the
PE period, beginning on the date a qualified provider (QP)
determines the woman to be presumptively eligible. The woman's
Hoosier Healthwise/Medicaid eligibility determination is
subsequently completed by the DFR.
Enrollment centers that are not qualified providers for the PE
program can assist pregnant women by helping them complete and
submit Hoosier Healthwise (HHW) applications and providing
referrals to qualified providers. However, it is critical that only
ONE HHW application be submitted for a member. For more
information, see BR200949, dated November 17,
More information is available via the links below.
Information about PE can also be found in archived Bulletins, Banner Pages and
Use the Keyword Search option to search for Presumptive