Great News for Ohio's New Moms

During the last Operating Budget process, the Ohio Legislature approved and fully funded a provision that would allow the Office of Medicaid to extend the current 60-day postpartum Medicaid benefit to 1 full year! This extension for Ohio's new moms goes into effect on April 1, 2022.

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The 12-month postpartum period begins on the last day of a beneficiary’s pregnancy and extends through the end of the month in which the 12-month period ends. Like the current 60-day postpartum period, under the extended postpartum coverage option, individuals are entitled to the extended postpartum coverage regardless of the reason the pregnancy ends.

Care during the postpartum period involves not just a single visit but a series of encounters and a range of services tailored to the needs of the beneficiary. Coverage during an extended postpartum period gives providers opportunities to assess beneficiaries’ physical recovery from pregnancy and childbirth, and to screen for, and provide care, to address conditions that can lead to morbidity and mortality in the later postpartum period. High quality, comprehensive postpartum care should address chronic health conditions (e.g., diabetes or hypertension), mental health and psychological well-being (e.g., postpartum depression, interpersonal violence), and family planning (e.g., contraceptive counseling).

Our nation’s rate of maternal mortality is rising – in fact, cardiovascular disease is the No. 1 killer of new moms – and a growing body of evidence shows some of the most dangerous pregnancy-related complications – preeclampsia, blood clots, and heart problems such as cardiomyopathy – may not surface until weeks or months after delivery.

The postpartum period is a time of vulnerability for all new mothers. This extension of Medicaid coverage for postpartum individuals will certainly help ensure new moms have continuous, uninterrupted access to care to address their ongoing health needs, including those unrelated to pregnancy.

The following populations will be provided continuous enrollment through the end of the 12-month postpartum period:

  • Current beneficiaries who are pregnant as of the effective date of the State Plan Amendment (SPA) or who enroll based on pregnancy or become pregnant after the SPA is effective;
  • Current beneficiaries who were enrolled in Medicaid or CHIP while pregnant and who are no longer pregnant when the SPA becomes effective, but who are still within a 12-month postpartum period; and
  • Individuals who apply for Medicaid after their pregnancy ends, but who received Medicaid-covered services in the state while pregnant on or after the effective date of the SPA, if such services were received during a period of retroactive eligibility granted under section 1902(a)(34) of the Act and 42 C.F.R. § 435.915(a), provided that they would have been eligible when they received such services if they had applied.

We are pleased that Ohio's lawmakers worked together to support this extension to ensure postpartum individuals who depend on this benefit can access the care they need for a full year of postpartum care.

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