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Correction: Presumptive Eligibility for Pregnant Women Automatic Extension

January 17, 2018

This article corrects the link provided in a previous NewsFlash article published on January 5, 2018.

Qualified Providers (QPs) of the Presumptive Eligibility for Pregnant Women Program (PE4PW) must remind individuals to complete an application for insurance affordability programs. QPs are required to provide applicants with a Single Streamline Application during the PE4PW application process.

The Medi-Cal Eligibility Data System (MEDS) automatically extends PE4PW coverage until a Medi-Cal determination is made if the insurance affordability application is received prior to the Presumptive Eligibility (PE) period end date. If no application is received by MEDS, the PE coverage ends on the last day of the month following the month of application. If a Medi-Cal determination is made prior to the PE period end date, the PE ends on the date the determination was made regardless if Medi-Cal is approved or denied.

If the recipient experiences a lapse in coverage and states that an insurance affordability application has been filed, the QP or the recipient should contact the appropriate county office to have the PE extended. The complete list of county offices is available on the County Offices to Apply for Health Coverage, Medi-Cal, and Other Benefits page of the Department of Health Care Services website.

Questions about PE4PW automatic extension may be sent to the following email address: PE@dhcs.ca.gov.