Family Planning, Access, Care and Treatment Program (Family PACT)

California residents can receive family planning services through the Family PACT Program, previously known as the State Only Family Planning Program (SOFP), when they meet the following criteria:

No other health coverage which covers family planning, and
Gross family income at or below 200% of the federal poverty level, and
Unmet share of cost (this criteria applies only for MC clients).

Note: There is no property limit or citizenship requirement for Family PACT.

The EW does not determine Family PACT Eligibility; healthcare providers determine Family PACT eligibility. The participating providers will enroll the eligible person in the Family PACT program, and issue a Health Access Programs (HAP) card for people who don’t have a valid BIC; or add Family PACT eligibility to the MC BIC. The provider is responsible for the HAP card replacement.

COVID-19 Uninsured Group Program

As of March 18, 2020, the Department of Health Care Services (DHCS) was directed to provide Presumptive Eligibility (PE) for coronavirus disease 2019 (COVID-19) to uninsured individuals who need diagnostic testing, testing-related services, and treatment services, including all medically necessary care related to COVID-19, at no cost.

On August 28, 2020, DHCS implemented the COVID-19 Uninsured Group Program that extends PE period.

Applications for this program are processed by existing qualified providers, who currently evaluate eligibility for Child Health and Disability Prevention (CHDP), PE for Pregnant Women (PE4PW), and Hospital Presumptive Eligibility (HPE). The EW does not determine the PE for COVID-19 program.

The COVID-19 Uninsured Group Program ends on May 31, 2023.

Eligibility Criteria

To qualify for PE for COVID-19, individuals must:

Be a California resident regardless of immigration status, income or resources, and
Have no health insurance, or
Have private insurance, but not covered for COVID-19 testing and treatment services including medical necessary care for COVID-19, or
Be not eligible for any Medi-Cal programs (with the exception of individuals who have not met their Share of Cost), or
Not have Medicare.

If an individual is determined to be eligible to CHDP, PE4PW, or HPE program, the individual will not qualify for the COVID-19 Uninsured Group program.

Period of Eligibility

The COVID-19 Uninsured Group Program covers COVID-19 diagnostic testing, testing-related services, and treatment services, including hospitalization and all medically necessary care, at no cost to the individual, for up to 12 months or the end of the public health emergency (PHE), whichever comes first.

Retroactive Eligibility

Applications for the COVID-19 Uninsured Group program can be retroactive to April 8, 2020. QPs can submit retroactive applications to COVID19Apps@dhcs.ca.gov for review and processing.

Aid Code in MEDS

Aid Code V2 is assigned in MEDS for the COVID-19 Uninsured Group program. MEDS will automatically terminate Aid Code V2 at the end of 12 month if no other Medi-Cal programs are evaluated.