Pregnancy Eligibility During the Covid-19 Public Health Emergency (PHE)

November 3, 2021

During the Covid-19 PHE, Medi-Cal beneficiaries are retaining coverage in the aid code issued prior to, or during the PHE. Beneficiaries in pregnancy related aid codes continue to remain eligible for non-pregnancy related services during this health crisis, beyond the end of their pregnancy through the duration of the PHE. Pregnancy related Medi-Cal was designated as providing minimum essential coverage (MEC) on July 1, 2015, and as such, provides coverage for the full breadth of medically necessary services. Providers are advised to continue to provide beneficiaries in pregnancy related aid codes with any medically necessary service, including non-pregnancy services, through the duration of the PHE. Providers should submit claims using the appropriate diagnosis codes in addition to using the pregnancy diagnosis code. No claim will be denied for medically necessary services that are not pregnancy related.

Questions concerning eligibility under pregnancy-related aid codes during PHE should be sent to Pregnancy@dhcs.ca.gov.