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Prenatal and Maternity Care

Medi-Cal Presumptive Eligibility Program

What is Presumptive Eligibility?
Presumptive Eligibility (PE) is a Medi-Cal program designed to provide immediate, temporary health care coverage for prenatal care to low-income pregnant women. You can find out more about Medi-Cal from the California Department of Health Services.

Who is eligible for PE?
Any woman who thinks she is pregnant and whose family income is under a certain amount (see the Medi-Cal Income Guidelines) is eligible for PE. However, she must seek prenatal care from a health provider who participates in the program.

If your income is greater than the maximum allowable for Medi-Cal, you may be eligible for the AIM program.

Will PE pay for the pregnancy test?
Yes, if you are eligible, PE will pay your provider for the cost of the pregnancy test even if the test turns out to be negative.

How long will I be eligible for PE?
You will be eligible for PE until your eligibility for Medi-Cal is determined. If you fail to apply for Medi-Cal, your eligibility for PE will end at the end of the month following the month in which you first apply for PE.

What services does PE cover?
PE covers all walk-in prenatal care services including lab tests and pharmacy drugs related to pregnancy. PE also covers outpatient abortion services. It does not cover emergency room, delivery or family planning services.

Don't Delay Seeing a Doctor or Midwife! You can find a local prenatal care provider who accepts Medi-Cal from our list of providers. These health care providers can help you obtain health coverage by qualifying you for Medi-Cal services right at their office.