DPSS ePolicy

• To convert existing policy to the new webpage - No content changes
• Revision of existing policy and/or form(s)

What changed?

1. Reminder for staff that MCAP eligible individuals must not be evaluated for Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal (MC) with a Share of Cost (SOC);
2. Clarification that a full MC Hierarchy is not needed if requested by an MCAP eligible applicant/beneficiary; and
3. Reminder for staff that pregnancy verification is not required.

MCAP provides comprehensive care for pregnant individuals at any point of the pregnancy and continues for the duration of their pregnancy and up to 60 days postpartum.  MCAP is managed by MAXIMUS, Inc. (MAXIMUS) through a partnership with the California Department of Health Care Services (DHCS).  As the administrative vendor, MAXIMUS is responsible for case management and billing activities for the program. 

Applicants may be: 

1. A pregnant individual age 18 or older applying for themselves; 
2. The spouse of a pregnant individual; 
3. A legal guardian, natural parent, foster parent, or stepparent with whom a pregnant non-emancipated minor resides; or 
4. A pregnant emancipated minor who is not living in the home of a natural parent, adoptive parent, a legal guardian, foster parent, or stepparent. 

MCAP eligible individuals must not be evaluated for Non-MAGI MC with a SOC.  Under the current MC Hierarchy, MCAP eligibility is considered under the MAGI category. 

After legislature approval in 1991, MCAP, formerly known as Access for Infants and Mothers (AIM), was a significant step in providing pregnant individuals with low-cost comprehensive health care coverage with no co-payments or deductibles.  MCAP is for families who do not have health insurance and whose income is between 214% - 322% of the Federal Poverty Level (FPL).  Children born to MCAP beneficiaries may be covered by the Medi-Cal Access Infant Program (MCAIP).

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