An Enroll America Toolkit to help maximize the number of Americans who enroll in health coverage

Pre-2014 PE Policies

States' Use of Presumptive Eligibility, January 2013

This map shows which states currently allow—or don’t allow—presumptive eligibility determinations for pregnant women and/or children. Note that all hospitals that participate in Medicaid will be able to conduct PE determinations in 2014.

Click here to enlarge this map.

State Presumptive Eligibility Provider Manuals

These are provider manuals for states that currently allow presumptive eligibility for pregnant women and/or children.

PE Availability*
Provider Manuals for Presumptive Eligibility
Alabama No Individuals  
Alaska No Individuals  
Arizona No Individuals  
Arkansas Pregnant Women Arkansas Provider Manual -- Section One
California Children and Pregnant Women California Provider Manual -- Presumptive Eligibility for Pregnant Women
Colorado Children and Pregnant Women Colorado Presumptive Eligibility Provider Manual
Colorado General Provider Information
Connecticut Children and Pregnant Women Connecticut Policy Manual -- Presumptive Eligibility
Delaware Pregnant Women Delaware Presumptive Eligibility Regulations
District of Columbia Pregnant Women District of Columbia Presumptive Eligibility Policy Manual
Florida Pregnant Women Florida Provider Manual
Georgia Pregnant Women Georgia Medicaid Issuance -- Presumptive Eligibility
Hawaii No Individuals  
Idaho Pregnant Women Idaho Provider Handbook
Illinois Children and Pregnant Women Illinois Provider Manual
Indiana Pregnant Women Indiana Presumptive Eligibility Provider Manual
Iowa Children and Pregnant Women Iowa Provider Manual -- Eligibility
Kansas Children Kansas Provider Manual
Kentucky Pregnant Women Kentucky Provider Manual -- Presumptive Eligibility
Louisiana No Individuals  
Maine Pregnant Women Maine Provider Manual – Eligibility
Maryland No Individuals  
Massachusetts Children and Pregnant Women Massachusetts Presumptive Eligibility Regulations – Children
Michigan Children and Pregnant Women Michigan MIChild Eligibility Manual
Michigan Provider Manual
Minnesota No Individuals  
Mississippi No Individuals  
Missouri Children** and Pregnant Women Missouri Provider Manual – Eligibility
Montana Children and Pregnant Women Montana Provider Manual
Nebraska Pregnant Women Nebraska Provider Manual -- Presumptive Eligibility
Nevada No Individuals  
New Hampshire Children** and Pregnant Women New Hampshire Presumptive Eligibility Application Process
New Hampshire Provider Form -- Notice of PE for Family Planning Medical Assistance
New Jersey Children and Pregnant Women New Jersey Administrative Code -- Presumptive Eligibility
New Mexico Children** and Pregnant Women New Mexico Presumptive Eligibility Determiner Form
New York Children and Pregnant Women New York Medicaid Update on Presumptive Eligibility
New York Provider Manual -- Prenatal Policy Section
North Carolina Pregnant Women North Carolina Provider Manual -- Presumptive Eligibility for Pregnant Women
North Dakota No Individuals  
Ohio Children** and Pregnant Women Ohio Provider Manual -- Eligibility
Oklahoma Pregnant Women Oklahoma Presumptive Eligibility Policy and Rules
Oklahoma Policy for Presumptive Eligibility for Pregnant Women
Oregon No Individuals  
Pennsylvania Pregnant Women Pennsylvania Provider Manual -- Authorizing Presumptive Eligibility
Rhode Island No Individuals  
South Carolina No Individuals  
South Dakota No Individuals  
Tennessee Pregnant Women Tennessee Presumptive Eligibility Rules
Texas Pregnant Women Texas Provider Manual
Utah Children and Pregnant Women Utah Provider Manual -- General Information Section
Utah Provider Manual -- Services for Pregnant Women
Vermont No Individuals  
Virginia No Individuals  
Washington No Individuals  
West Virginia No Individuals  
Wisconsin Children** and Pregnant Women Wisconsin Guide to Determining Presumptive Eligibility for Pregnant Women
Wisconsin Prenatal Care Coordination Services Manual
Wyoming Pregnant Women Wyoming General Provider Manual
*Presumptive Eligibility for Children Either through Medicaid or CHIP
** Medicaid only

Current State Medicaid Eligibility Guidelines

This table shows states’ current income eligibility levels for adults, pregnant women, and children.

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