Medi-Cal Access Program (MCAP)

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Medi-Cal Access Program (MCAP)


1.

What services are offered?

Prenatal visits and hospital delivery.  Full health care services during pregnancy and 60 days after.  Full health care services for the baby born from the MCAP covered pregnancy (for the first two years).  Babies are automatically eligible for the Medi-Cal Access Infant Program unless they are enrolled in employer-sponsored insurance or no-cost Medi-Cal.

2.

Who can be covered?

Pregnant women (not more than 30 weeks at the time of the application) and the baby resulting from the MCAP-covered pregnancy (birth to 2 years old).  You will receive an Infant Registration Form approximately 30 days prior to your delivery date and you must return the complete form within 30 days after delivery.

3.

Is there an income limit?

Yes, verified monthly income limit is 213% and 322% of the Federal Poverty Level.  See the Monthly Income chart for the amounts.

Monthly Income

Family Size (count pregnant woman as 2)

Income Limit
213% & 322%

2

$2,883 - $4,358

3

$3,625 - $5,480

4

$4,367 - $6,601

5

$5,109 - $7,723

6

$5,851 - $8,845

7

$6,593 - $9,966

8

$7,335 - $11,088

 

4.

Is there a property limit?

No.

5.

Can an individual receive services if he/she has other health insurance?

Yes, but only if your insurance does not cover maternity care or if you have a separate maternity deductible or copay over $500.  You are not eligible to MCAP if you qualify for no-cost Medi-Cal.

6.

How much does it cost?

One and a half percent (1.5%) of your Modified Adjusted Gross Income (MAGI).  This is a total cost, not a monthly premium.  You can pay the 1.5% cost when you submit your application, or you may make monthly payments for one year.  (A $50 discount will be given if you send your full 1.5% cost with your application).

7.

What is the Modified Adjusted Gross Income (MAGI)? 

Starting January 1, 2014, the Affordable Care Act (ACA) requires the new Modified Adjusted Gross Income (MAGI) guidelines are to be used to determine the eligibility of pregnant women for the MCAP Program.  MAGI counts income and include people in household based on your annual federal tax form.  MCAP then compares the federally countable MAGI for the household size you claim on your federal taxes to the federal income guidelines.

8.

Is citizenship or legal residency required?

No, but you must be living in California and plan to stay in California.

9.

How to file an application?

To request a brochure and an application, call (800) 433-2611.  For additional information, visit the MCAP program website.