Presumptive Eligibility

Presumptive Eligibility 2017-09-07T19:46:07+00:00

 

Early pregnancy diagnosis leads to healthier deliveries for both the mother and baby. Clinica Medica Familiar offers a NO-COST, FREE pregnancy test through its Presumptive Eligibility Program. If a pregnancy test is positive, emergency Medi-Cal eligibility is available.

The Presumptive Eligibility program for pregnant women is designed for low-income California residents who believe they are pregnant and who do not have health insurance or Medi-Cal coverage for prenatal care.

Information For Pregnant Women Interested In Presumptive Eligibility (PE)

Who is eligible?

Any woman who thinks she is pregnant and whose family income is under a certain amount is eligible for Presumptive Eligibility (PE) for Pregnant Women. Clinica Medica Familiar offers this program and can determine if you are eligible.

What kind of prenatal care can I receive when enrolled in the PE Program?

PE offers specific walk-in prenatal care and prescription drugs for conditions related to pregnancy.

What care is NOT covered by the PE Program?

PE is a temporary Medi-Cal program that does not cover labor and delivery, or inpatient care. That is why it is important for PE patients to apply for Medi-Cal on a timely basis.

Who will help me enroll in the PE program?

A dedicated Clinica Medica Familiar employee.

What happens at the first appointment?

Clinica Medica Familiar will ask you to complete a Statement of California Residency (English | Spanish) and then a “Presumptive Eligibility for Pregnancy Only” application. If you are determined eligible for PE, Clinica Medica Familiar will then complete your NO COST FREE pregnancy test. If your pregnancy test is negative, you will not be eligible for PE. If your test is positive, you will be issued a temporary Medi-Cal card (paper) for PE only (up to 2 months). This card IS NOT A MEDI-CAL CARD. It is only for specific PE services. The provider will complete your examination and then schedule you for your next appointment.

What next?

You must formally apply for Medi-Cal at the County Department of Social Services and provide proof of application to Clinica Medica Familiar before the expiration date on your temporary Medi-Cal card (paper). Clinica Medica Familiar will then extend your temporary Medi-Cal card for up to 2 months. The county will determine if you are eligible to receive Medi-Cal. If you are determined to be eligible for Medi-Cal you will be mailed a Medi-Cal Beneficiary Identification Card.

What do I do with the Medi-Cal card when it comes in the mail?

You should notify Clinica Medica Familiar that you now have Medi-Cal. You should stop using your temporary Medi-Cal Card (paper) and begin using your new Medi-Cal card.

What if I have more questions about the PE program?

You can contact Ontario Clinica Medica Familiar (909) 988-3288 or Rialto Clinica Medica Familiar (909) 877-8868, or a PE Support Unit at (800) 824-0088.