The Presumptive Eligibility for Pregnant Women program provides low income pregnant women with immediate, temporary MC coverage, limited to ambulatory prenatal care, while their regular MC (or CalWORKs) application is pending.
Hospital Presumptive Eligibility
Express Lane Enrollment
Accelerated Enrollment (AE) -
Consumer Protection Programs
Transitional Medi-Cal
Transitional Medi-Cal -TMC is a consumer protection program. This program is for individuals who become ineligible for CalWORKs (CW), parent/caretaker relative MAGI MC, and child MAGI MC aid codes due to increased earnings. TMC may provide up to 12 months of zero share of cost (SOC) MC coverage.
Four-Month Continuing Eligibility -The Four-Month Continuing program provides four months of zero SOC MC for individuals who are discontinued from CW, parent/caretaker relative MAGI MC, and child MAGI MC aid codes due to the collection of or increased collection of child/spousal support.
Edwards vs. Kizer dictates that an individual must be place onto a transitional aid code, when an individual is discontinued from CalWORKs, to allow time for a full MC determination
Continuous Eligibility for Children (CEC)
CEC ensures that all children under age 19 who are determined eligible for zero SOC MC maintain eligibility until the next annual redetermination or the child turns 19, whichever occurs first. All adverse changes in financial eligibility income, property, including a change in maintenance need levels, are disregarded until the CEC period ends. Medi-Cal Benefits for Refugees
Refugees and Entrants may be eligible for MC through the Refugee Medical Assistance program or the Entrant Medical Assistance program.