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What You Need to Know After You Are Enrolled

In order for MCAP to continue to provide services, you must help us in the following ways:

Changing Your Address

You must write to MCAP to inform them of any changes with your home phone or billing address or if you move out of state. This letter must be sent 30 days before you move.

Mail or FAX your letter to:

Medi-Cal Access Program
P.O. Box 15559
Sacramento, CA 95852-0559
FAX: (888) 889-9238

If You Get Other Insurance

If you get other insurance after you are enrolled in MCAP, you must write to the MCAP (at the address shown above) right away. This is very important because MCAP only pays for benefts not covered by your other insurance. You will still have to pay your share of the cost for MCAP coverage (1.5% of your income).

Transferring to Another Health Plan within MCAP

In most cases, the health plan you sign up will be the plan you will stay with until your coverage ends. There are only three reasons for which you may transfer or be transferred to another MCAP health plan.

  1. You may request to transfer from one MCAP health plan to another if you move to an area that your original health plan does not serve.

    The request must be submitted in writing within 30 days before you move.

    If approved, the transfer will take effect within 17 calendar days of the date the program received your request.

  2. You or your health plan may request a transfer because the two of you do not have a good relationship. These requests will only be approved if the transfer is in the best interest of the program. There must also be another MCAP provider available where you live. The transfer will take effect within 15 calendar days from approval of the transfer.
  3. You may be transferred to another MCAP health plan if the one that you are enrolled in is no longer participating with MCAP. The transfer would take effect prior to the end of the health plan contract.

All transfer requests must be approved by the MCAP.

Mail or FAX your letter to:

Medi-Cal Access Program
P.O. Box 15559
Sacramento, CA 95852-0559
FAX: (888) 889-9238

How long can you be enrolled in MCAP?

When will your coverage end?

If you are enrolled, the MCAP will provide comprehensive health care during your pregnancy and through the last day of the month in which the 60th day following the end of the pregnancy occurs. MCAP is only for one pregnancy at a time and cannot cover services received after the last day of the month in which the 60th day from when your pregnancy ended. You must notify MCAP within 30 days after the end of your pregnancy.

What you need to do once your baby is born?

MCAP will mail you an Infant Registration Form 30 days before your estimated date of delivery and you need to return the completed form. You may also use the Infant Registration Form. If you have your baby early or you do not want to register your baby for public coverage, you still must notify the MCAP within 30 days from when your pregnancy ends. MCAP cannot cover any medical services you receive after the last day of the month in which the 60th day from when your pregnancy ended.

What if you have a difficult pregnancy?

MCAP provides comprehensive health care for your pregnancy in an effort to help you. MCAP understands that sometimes women have difficult pregnancies, and is sorry for any difficulties you may experience. If you are still pregnant after your start date of coverage, MCAP will provide comprehensive health care during your pregnancy and through the last day of the month in which the 60th day following the end of the pregnancy occurs.

MCAP cannot cover any medical services you receive after the last day of the month in which the 60th day following the end of your pregnancy occurs. You need to notify MCAP within 30 days after the end of your pregnancy.

What if you are no longer pregnant before your start date of coverage?

If you are no longer pregnant before the first day that your MCAP coverage starts, your coverage will not begin. You must immediately inform MCAP within 30 days of the date that you were no longer pregnant. MCAP cannot cover any medical services you receive if you are no longer pregnant before your start date of coverage.

You must notify MCAP within 30 days of the end of your pregnancy, even if you have an early end to your pregnancy. You may use the Early End of Pregnancy Form. If notification to the program is received after the start date of coverage, documentation by a licensed or certified health care professional must be submitted indicating the end date of your pregnancy.

What if you are no longer pregnant after your start date of coverage?

If you are no longer pregnant by the end of your first trimester, you may be eligible for a reduced subscriber contribution. If your pregnancy ends after your first trimester, you will still be responsible for the full 1.5% cost.

You must notify MCAP within 30 days from when your pregnancy ends, to inform us of the date that you were no longer pregnant. MCAP cannot cover any medical services you receive after the last day of the month in which the 60th day following the end of your pregnancy occurs. You may use the Early End of Pregnancy Form to inform MCAP that your pregnancy has ended. If you want to be considered for a reduced subscriber contribution, documentation by a licensed or certified health care professional must be submitted indicating the end date of your pregnancy.

How do you notify MCAP?

You must notify the MCAP within 30 days of the date that your pregnancy ended.

Mail or fax your letter to:

Medi-Cal Access Program
P.O. Box 15559
Sacramento, CA 95852-0559
Fax: 1-888-889-9238

If you would like to request a form or have questions regarding your MCAP coverage, please call the MCAP Monday through Friday, 8:00 a.m. to 8:00 p.m., or on Saturday, 8:00 a.m. to 5:00 p.m. at 1-800-433-2611.