The family planning waiver program covers family planning services to eligible women, ages 14 through 55. Services are provided up to 24 months. Eligibility is limited to family incomes at or below 185 percent of the Federal Poverty Level who are not otherwise eligible for Medicaid, Children’s Health Insurance Program, or health insurance coverage that provides family planning services; and who have lost Medicaid eligibility within the last two years. This includes women losing Medicaid managed care coverage.
Recipients losing SOBRA (pregnancy Medicaid) eligibility will have passive enrollment during the first 12 months of losing Medicaid. Non-SOBRA women will have to actively apply for the first year of benefits at their local county health department. All women enrolled in the family planning waiver will have active re-determination of eligibility through their local county health department after 12 months of family planning waiver eligibility. In order to receive the second year of benefits, recipients must reapply at their local county health department.
The family planning waiver program covers the following services:
The family planning waiver program does not cover the following services:
For additional information, please call 1-877-254-1055 (8:00 a.m. ET - 5:00 p.m. ET).
The Agency for Health Care Administration is seeking to extend federal waiver authority to continue providing Medicaid eligibility to the family planning waiver population. For more information, please visit the waiver extension web page. We encourage you to visit the web page frequently for updated information.