Pregnancy
Medi-Cal and the Medi-Cal Access Program (MCAP) provide eligible pregnant individuals with medically necessary services during pregnancy and postpartum. Additional information and the application process for MCAP can be found here: Medi-Cal Access Program.
Pregnancy care includes prenatal, pregnancy-related services, and postpartum services.
Medically necessary prescribed medications, laboratory services, radiology, tobacco cessation services, mental health services, substance use disorder services and dental services as defined in the Medi-Cal Dental Manual of Criteria are among the covered services of the Medi-Cal program during pregnancy and the postpartum period for all pregnant patients.
Individuals can apply for Medi-Cal benefits in multiple ways.
Covered California Online |
www.CoveredCA.com |
Telephone
|
1-800-300-1506
|
In Person
|
Contact Covered California on-line or call the 800 number for a list of places
|
Download and print a CoveredCA application
|
Fax to: 1-888-329-3700
- or -
Mail to:
Covered California
P.O. Box 989725
West Sacramento, CA 95798
|
Contact the Local County Human Services Agency
|
County Office Listings
|
American Rescue Plan Act (ARPA) Postpartum Care Extension (PCE)
As part of the American Rescue Act Plan (ARPA), effective April 1, 2022, an individual eligible for pregnancy and postpartum care services under Medi-Cal or the Medi-Cal Access Program (MCAP) is entitled to 365 days (12 months) of postpartum care coverage. This coverage shall include the full breadth of medically necessary services during pregnancy and the postpartum period. ARPA PCE is automatic for all Medi-Cal or MCAP eligible individuals who report a pregnancy or are postpartum, regardless of immigration status or how the pregnancy ends. The individual does not have to request it or provide any additional information. Questions concerning this expansion of postpartum care should be sent to Pregnancy@dhcs.ca.gov.
The ARPA PCE replaced the Provisional Postpartum Care Extension (PPCE), which ended on March 31, 2022.
All County Welfare Directors Letters (ACWDLS)
Letter No. 21-15: Subject: Postpartum Care Extension
Medi-Cal Eligibility Division Information Letters (MEDILS)
Letter No. I 21-13: Subject: Postpartum Care Extension Implementation
Letter No. I 21-13E: Subject: Postpartum Care Extension Implementation
ARPA PCE Flyer
Frequently Asked Questions
-
What is the authority for implementing ARPA PCE?
H.R. 1319, the American Rescue Plan Act of the 117th Congress 2021–2022 (ARPA) (Pub. Law 117-2).
-
When will the ARPA PCE implement?
-
What will ARPA PCE provide?
Individuals will receive the full breadth of medically necessary services, including abortion during both the pregnancy and postpartum periods. The postpartum period is extended to provide an additional ten months of coverage following the current 60-day postpartum period, for a total of 12 months (365-day postpartum period).
-
Who is eligible for ARPA PCE?
Individuals if pregnant or postpartum, who are Medi-Cal or the Medi-Cal Access Program (MCAP) eligible, will be provided the full breadth of medically necessary services and the postpartum extension regardless of income, citizenship, or immigration status. ARPA PCE is granted no matter how the pregnancy ends.
-
How does an individual receive ARPA PCE?
When an individual reports that they are pregnant or has been recently pregnant, and are Medi-Cal or MCAP eligible, ARPA PCE is granted. The individual is not required to take additional action.
-
How long does it take to receive the ARPA PCE determination?
ARPA PCE is granted with the pregnancy or postpartum eligibility determination.
-
When does the ARPA PCE period begin and end?
The ARPA Postpartum Care Extension period begins on the day following the last day of pregnancy and ends on the last day of the month in which the 365th day falls.
-
How can health care providers verify that the beneficiary has ARPA PCE?
Individuals in ARPA PCE will remain in the same coverage assigned during pregnancy until the end of the 365-day postpartum period. Providers can verify that the beneficiary has continued eligibility by using the Automated Eligibility Verification System, a Point of Service device, or the Medi-Cal website.
-
Where can individuals receive more information about PPCE?
Individuals may read the ARPA PCE flyer available on this web page. Individuals may also contact their local county Medi-Cal office or the MCAP program if they have questions about their specific case.
Articles