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MODULE 5 The 24-Month Post-Partum Family Planning Extension Program (FPEP)

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Presentation on theme: "MODULE 5 The 24-Month Post-Partum Family Planning Extension Program (FPEP)"— Presentation transcript:

1 MODULE 5 The 24-Month Post-Partum Family Planning Extension Program (FPEP)

2 What is the Family Planning Extension Program? * Provides 24 months of family planning services coverage to women who received Medicaid coverage during their pregnancy and are no longer eligible for Medicaid or FHPlus at their 60 day Post-partum renewal point *This program is funded with 100% State-only funds

3 Who is Eligible for the FPEP? *To be eligible, a woman must have been pregnant while on Medicaid *Must not be eligible for Medicaid, FHPlus or FPBP *Women are eligible for this coverage regardless of citizenship/immigration status, income, or how the pregnancy ended * Even if no renewal is sent back, those women who received Medicaid coverage during their pregnancy will receive this coverage automatically

4 FPEP Exceptions The following individuals will not receive the 24-month guarantee family planning services coverage: * Women that have moved outside of New York * Renewal form was returned to NYS DOH as “Unable to locate” * Client request

5 FPEP Benefits * Benefit package for FPEP is the same as FPBP EXCEPT that transportation services are NOT included * Provided in a continuous 24-month block of coverage for family planning services * A women’s current CBIC (benefit card) will remain active for FPBP/FPEP for the 24-month guarantee period

6 Family Planning Providers * Family Planning providers should: Encourage all women to complete and return their renewal packet during the post-partum period Keep their current address updated with their local department of social services (LDSS) or the Human Resources Administration (HRA) * If a provider believes that a woman, who is currently on FPEP, is eligible for FPBP, the provider should conduct an FPBP PE Screening and have the woman fill out an FPBP application –Reminder, FPEP is funded only with State money, while FPBP is funded with 90% Federal funds and 10% State funds

7 FPBP/FPEP Eligibility Process * If the women is ineligible for Medicaid or FHPlus at her 60-day post partum renewal, eligibility will be determined for FPBP – If eligible for FPBP, a woman will be enrolled into FPBP for 12 months She will receive an FPBP renewal at the end of the 12 months. –If she remains eligible for FPBP she will continue to receive services through FPBP and receive FPBP renewals –If she is ineligible, or fails to return her renewal form, she will receive 12 months of FPEP, which is the remainder of the 24 months of post partum family planning services – »12 months FPBP and 12 months FPEP

8 FPEP Eligibility Process * If the women is ineligible for Medicaid or FHPlus at her 60-day post partum renewal, eligibility will be determined for FPBP If ineligible for FPBP, a woman will be enrolled into FPEP for 24 months * Women on FPEP will not get a renewal form at the end of the 24 months but may apply for FPBP or Medicaid if she believes she is eligible for such program

9 Memory Point *Women on FPEP will receive a 24-months of family planning services through: –FPBP 24-months, OR – FPEP 24-months, OR – A combination of the 2 programs

10 Case Examples

11 Shari Villa »Married to Alvino Villa »Her daughter, Lily, is 7 months old »She is a New York State resident and a U.S. Citizen »Alvino recently was promoted to an Assistant Manager of a small grocery store and earns $40,000 a year »Alvino’s employer offers health insurance but it has a very high deductible

12 Shari Villa, cont’d Shari was on Medicaid while she was pregnant with her daughter. When Shari returned her Medicaid renewal she was found ineligible for Medicaid, FHPlus and FPBP because her husband Alvino was now earning more money in his new position and their household income was over 200% of the Federal Poverty Level. At the end of her 60-day post partum period on Medicaid, Shari received a Medicaid notice explaining that she will now have access to 24-months of family planning services and that she can continue to use her CBIC to receive those services. Since her insurance has a high deductible, Shari is using her FPEP benefit to receive family planning services.

13 Uma Patel Uma is married to Trishul Her son, Kiran, is 4 months old Uma lives in New York State She does not have satisfactory immigration status

14 Uma Patel, cont’d Uma was on Medicaid while she was pregnant with her son. When Uma returned her Medicaid renewal she was found ineligible for Medicaid, FHPlus and FPBP because she does not have satisfactory immigration status. –Uma did not claim to have an immigration status and the only document that Uma has is her VISA from India At the end of her 60-day post partum period on Medicaid, Uma received a Medicaid notice explaining that she will now have access to 24-months of family planning services and that she can continue to use her CBIC to receive those services.

15 Amber Forlano »Amber is a single mother »Her son is 13 months old »She was on Medicaid while pregnant »She received 12 months of FPBP after 60-day post partum period ended »Amber is employed as an Administrative Assistant

16 Amber Forlano, cont’d Amber was enrolled in Medicaid while she was pregnant with her son. When Amber received her Medicaid renewal during her 60-day post partum period, she returned it and was found eligible for FPBP. Amber continued to receive FPBP services for 12 months. Toward the end of the 12-month coverage period, Amber received an FPBP renewal form. When Amber returned her FPBP renewal form, she reported an increase in income as she began working full time at her job.

17 Amber Forlano, cont’d A determination was made and Amber was found inelgible for FPBP. However, since Amber was on Medicaid while she was pregnant with her son, she is eligible for a total of 24 months of family planning services after her 60-day post partum period. Amber received a Medicaid notice explaining that she will now have access to 12-months of family planning services through FPEP and that she can continue to use her CBIC to receive those services.

18 Tamika Kelley »Tamika is 18 years old »She is a full time student »She lives at home with her parents »Tamika was on Medicaid while pregnant

19 Tamika Kelley, cont’d Tamika’s pregnancy was terminated She did not respond to the renewal packet that was sent during her 60 day post partum period At the end of her 60-day post partum period on Medicaid, she received a Medicaid notice explaining that she will now have access to 24- months of family planning services and that she can continue to use her CBIC to receive those services.

20 Sara Wood

21 Sara Wood, cont’d Sara, a 23 year old new mother, was on Medicaid while pregnant with her daughter. When Sara received her Medicaid renewal, she forgot to return it. At the end of her 60-day post partum period, on Medicaid, Sara received a Medicaid notice explaining that she will now have access to 24-months of family planning services and that she can continue to use her CBIC to receive those services.

22 Sara Wood, cont’d A few months after Sara’s daughter was born, Sara decided to got to a family planning clinic to discuss starting on a form of birth control. She presented her CBIC to the clinic and the provider was able to see that she had FPEP coverage. After a discussion with Sara, the provider found out that Sara forgot to return her Medicaid renewal a few months ago and though that she might be eligible for FPBP rather than FPEP. The provider screened Sara for FPBP. Based on the information Sara told the provider, she was found presumptively eligible for FPBP. Sara also submitted an application for FPBP and the necessary documents for FPBP so that she could have her eligibility determined for FPBP.

23 This is the final training module for the 2012 changes to the Application and Enrollment training for the Family Planning Benefit Program. The following slide contains contact information you may find useful for FPBP Processing Activities Thank you for your participation in the Family Planning Benefit Program

24 Contacting the NY Enrollment Center FPBP Provider Phone Line FPBP Fax Line Good Cause Authorization Phone Line FPBP Mailbox PO Box Albany, NY


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