Pregnant (PG) Mother and a Deemed Newborn Eligibility Results

It is important to know how the VaCMS determines household size for a pregnant (PG) mother and newborn in order to correctly understand the eligibility results. After a PG mother has her baby, the eligibility results may look incorrect -- as if newborn were counted twice (once as an unborn child and once as a newborn). However, despite the strange look of the household count, the eligibility results that display on the Eligibility Summary page are correct.

If the mother applies while she is still pregnant, the mother and the unborn child are counted.

The mother is evaluated only one time – during pregnancy. Her eligibility results do no change after the end of pregnancy; in other words, her results carry through the post-partum period.  

With regard to the unborn child, please note that the VaCMS does not count the unborn child when determining the household or eligibility for anyone else in the household. The unborn child is only counted for the mother and counted only at the time she is evaluated as a pregnant woman (PG).  

If the mother applies after the baby is born and if it is within the three month retroactive period and if the VaCMS is evaluating the mother in a PG woman group, the VaCMS counts the unborn child in that determination even though the child may already be born.

The child who, by this time has been born, should be entered as a deemed newborn. See the Quick Reference Guide (QRG) titled “Adding a Deemed Newborn to a Case” for details. Including the child on the case as a deemed newborn does not impact the eligibility results of the retro PG mother.  

Though the household count for a mother and newborn looks like 3, the eligibility results for each EDG are correct.

Updated 10/03/2016