Access for Infants and Mothers Program Banner

Congratulations!

You have a baby on the way! The State of California wants to help you get good health care during your pregnancy. Going without prenatal care can cause many problems for you and your baby. Studies show that women who do not get prenatal care often have more complicated (and expensive) births. If you don’t have insurance to cover your pregnancy and you are not receiving no-cost Medi-Cal or Medicare Part A and Part B, the Medi-Cal Access Program (MCAP) may be the helping hand you and your baby need. MCAP can also help if you have other health insurance that doesn't cover maternity services or with a maternity-only deductible or copayment greater than $500. Check with your other health insurance plan to see if your deductible or copayment is for maternity-only services.


Family Photo Coverage through Medi-Cal Managed Care Delivery System (MMC) (Posted on 6/30/2017)

Effective July 1, 2017, new enrollees eligible for Medi-Cal Access Program (MCAP) will receive health care services (medical, dental, and vision coverage) through the Medi-Cal Managed Care (MMC) delivery system until the end of the month of the 60th day following the end of their pregnancy (post-partum eligibility period).

When you first qualify for MCAP and receive your Benefits Insurance Card (BIC), you are covered under Medi-Cal Fee-For-Service (FFS, also called, Regular Medi-Cal). You can use your BIC for health care services through Medi-Cal FFS from enrolled Medi-Cal providers until you enroll into a managed care health plan. The Health Care Options (HCO) Program will mail information explaining your health plan options and enrollment packets about managed care plans to all MCAP members who enrolled on or after July 1, 2017. Contact MCAP at 1-800-433-2611 if you have not received your BIC.

If you have not received your enrollment packet from HCO or need assistance selecting a plan or finding providers, please contact the HCO Call Center toll free at 1-800-430-4263, between 8:00 a.m. to 5:00 p.m., Monday-Friday. You may also visit the HCO website for more information about HCO – Medi-Cal Managed Care.

For benefits related questions you can visit the benefits website, or contact the Benefits Division at 1-800-541-5555.

MCAP eligible pregnant members who enrolled on or after October 1, 2016, up through June 30, 2017, will continue to receive full-scope services through the Medi-Cal FFS delivery system until the end of their post-partum eligibility period.

MCAP members who enrolled into the program prior to October 1, 2016, continue to receive coverage through their selected MCAP health plan.

All MCAP members will remain in their assigned health plan and delivery system until the end of the month of the 60th day following the end of their pregnancy to maintain continuity of care. No MCAP members will be transitioned from one delivery system to another.

Family Photo Coverage through Medi-Cal Fee-For-Service Delivery System (Posted on 11/15/16)

Effective October 1, 2016, all new MCAP enrollees no longer choose a health plan. Health care services including, dental and vision, are now provided through the Medi-Cal Fee-For-Service (FFS) delivery system. For FFS benefits related questions you can visit http://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-Cal_EHB_Benefits.aspx, or contact the Benefits Division at 1-800-541-5555. You will be sent a Medi-Cal Benefits Identification Card (BIC) in the mail, and you can use your BIC for health care services through Medi-Cal FFS from enrolled Medi-Cal providers. Please remember that you need to see a doctor who accepts Medi-Cal FFS. If your doctor doesn’t accept Medi-Cal FFS, you should contact another Medi-Cal provider. Remember to take your BIC with you when you get all medical services, including pharmacy, x-rays, and office visits. All Medi-Cal providers use the BIC to check your Medi-Cal eligibility. Contact MCAP at 1-800-433-2611 if you have not received your BIC.

For medical care providers, you may contact your local county human services agency who may be able to help you find a medical provider or provide a list of providers in your area.

For dental care providers, you may visit the Denti-Cal website at www.denti-cal.ca.gov, or contact the Denti-Cal call center at 1-800-322-6384.

For vision care providers, you may visit the on-line directory at http://www.dhcs.ca.gov/provgovpart/pharmacy/Pages/VisionDr.aspx, or contact vision@dhcs.ca.gov if you have questions.

MCAP members who enrolled into the program prior to October 1, 2016, continue to receive coverage through their selected MCAP health plan.

Family Photo Process to switch from Covered California to the Medi-Cal Access Program (MCAP) (Posted on 3/31/16)

Women enrolled in a Covered California health plan with income in the MCAP income range have the choice to leave their Covered California health plan and enroll in MCAP during pregnancy without a gap in coverage. But not all providers take MCAP. So if you want to keep your current medical provider(s), be sure to check if they take MCAP before switching. Read more bullet

Family Photo (Posted on 09/08/15)

Effective September 1, 2015, if your household income has changed you can submit a Medi-Cal Access Program Contribution Re-Evaluation Form to see if you qualify to lower or waive your monthly contribution.

Family Photo IMPORTANT INFORMATION FOR PREGNANT APPLICANTS
(Posted on 06/26/15)

You may be eligible for Medi-Cal, the Medi-Cal Access Program, or Covered California during your pregnancy and immediate postpartum. Read more bullet

Family Photo The 30 week pregnancy limit is no longer an eligibility requirement to qualify for MCAP
(Posted on 03/02/15)

Effective March 1, 2015, the Medi-Cal Access Program (MCAP) no longer has a 30 week pregnancy limit for MCAP applicants. Pregnant women can apply at any time during their pregnancy but must meet all other MCAP eligibility requirements in order to be determined eligible. If you have any questions on this program change, please call 1-800-433-2611.

Family Photo Protecting yourself and your baby from pertussis (whooping cough)
(Posted on 07/24/14)

Pertussis (whooping cough) is a highly contagious disease that can be spread by coughing. People with pertussis have severe coughing attacks that can last for months. Read more bullet

Family Photo What is Modified Adjusted Gross Income (MAGI)?
(Posted on 02/10/14)

Starting January 1, 2014, the Affordable Care Act (ACA) requires the new Modified Adjusted Gross Income (MAGI) guidelines are to be used to determine the eligibility of pregnant women for MCAP. Read more bullet

Family Photo Surrogate Mother Benefits Not Available through MCAP
(Posted on 01/12/12)

Effective February 1, 2012, maternity services for a paid surrogate mother will not be covered under the MCAP. A paid surrogate mother is a person who has made an agreement before the pregnancy to become pregnant and deliver a child for another person for monetary compensation other than medical and living expenses.

Family Photo Important Information for All Expecting Parents!
(Posted on 12/15/10)

Congratulations! You have a baby on the way! Read more bullet