Covered California Medi-Cal enrollment changes for pregnant women and former foster youth.
Covered California has updated their online application for 2016 open enrollment to automatically determine the eligibility of former foster youth and pregnancy coverage for Medi-Cal programs. In previous online versions the applicant was directed to the respective program for more information and final eligibility determination. In many situations the new Covered California enrollment website will help place the individual directly into the program they are eligible for.
Changes to the Covered California enrollment portal were reviewed in a November 24th Open Enrollment information webinar. The discussion of the new Medi-Cal program enhancements within Covered California begins 47 minutes into the recording or on page 58 of the PDF file.
Former foster youth (FFY) are eligible for full-scope no-cost Medi-Cal benefits under certain requirements. They can apply any time through Covered California and get a determination on their eligibility to receive FFY Medi-Cal even if they are in a mixed-status household.
Former Foster Youth (FFY) Eligibility Requirements
- Provides no-cost full scope benefits
- In foster care at age 18 or older in any state
- Living in California now
- Eligibility up to age 26
- No income or assets test
- Qualify regardless of placement type while in foster care
- Qualify regardless of immigration status
- Enroll any time
- No open enrollment period –FFY can apply at any time
- Apply through CoveredCA/CalHEERS
Alternatively, FFY can apply directly through their county Medi-Cal office using the MC250A streamlined application. For more information visit http://www.childrennow.org/files/4514/2861/8455/Coveredtil26_CountyContactList.pdf
Pregnant women have several options for either sole Medi-Cal coverage of additional health insurance coverage through Medi-Cal. Both the Medi-Cal Pregnancy Coverage and the Medi-Cal Access Program (MCAP) overlap with Covered California enrollment. Medi-Cal Pregnancy coverage will provide additional cost-sharing benefits for household incomes up to 213% of federal poverty line (FPL) while MCAP is available for households up to 322% of the FPL.
Medi-Cal Access Program
- Provides full-scope low-cost health coverage for pregnant women, regardless of immigration status
- Targeted for middle-income families with no health insurance whose income is too high for no-cost Medi-Cal
- Eligibility based on income and family size
- Total cost (subscriber’s contribution) is 1.5% of subscriber’s Modified Adjusted Gross Income (MAGI)
- MCAP is for uninsured women
- MCAP subscriber must be a resident of California
- Monthly household income must be above 213% of the Federal Poverty Level (FPL) but not exceed 322% FPL
- Must agree to pay the complete subscriber contribution
- Enroll anytime
MCAP eligibility results mean that the enrollee’s information will be automatically sent to the MCAP program and she will be contacted to complete enrollment
Current Covered California enrollees may choose to switch to MCAP instead
Consumers contact MCAP to ensure MCAP eligibility and enrollment before terminating a Covered California Health Plan
Previously uninsured pregnant women will first be eligible for MCAP, with the option to switch to Covered California during open enrollment, or after the birth of the baby, or other qualifying life event
Visit the MCAP website at www.mcap.dhcs.ca.gov
