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Covered California adds Medi-Cal option for some pregnant women

Photo by Frank de Kleine via Flickr Creative Commons

As of this week, uninsured pregnant women who make a moderate income can now apply through Covered California for a special Medi-Cal program for expectant mothers.

The Medi-Cal Access Program is designed for pregnant women who make too much to qualify for regular Medi-Cal and between 213 and 322 percent of the federal poverty level ($33,936 and $51,312 a year). Those are the qualifying amounts for a family of two, but under the rules of the program, a pregnant woman counts as at least two people for income purposes.

The program has been available through private insurers outside of Covered California, but until now it was not an option for those shopping on the state exchange. As a result, many women who would have qualified for Medi-Cal Access enrolled in more expensive plans.

Under the Medi-Cal Access Program, pregnant women with no other household members pay monthly premiums ranging from $42 to $64, depending on their income, according to the Los Angeles-based Maternal and Child Health Access. There are no copays or deductibles for any services provided through the program. Private plans purchased through Covered California tend to charge hospital copays and deductibles for labor and delivery, though subsidies are available to lower-income women.

The Medi-Cal Access Program is distinct from Medi-Cal. Enrollees don't have access to to Medi-Cal's benefits or provider network.

Covered California's three-month open enrollment period begins November 1, but enrollment for the Medi-Cal Access Program is year-round.