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​​​​​Children's Presumptive Eligibility​​

What Is Children's Presumptive Eligibility?​

Children's Presumptive Eligibility allows certain health care providers to approve temporary health coverage for eligible applicants using an electronic application. Children's Presumptive Eligibility determinations are based on the family's self-attestation of facts and no other forms of proof are required.

Children's Presumptive Eligibility provides immediate temporary, full-scope benefits on a Fee-For-Service basis for up to 60 days for those who qualify. Families should apply for health coverage programs and complete the application process to find a long-term health insurance program that fits their needs. See below for ways to apply for health coverage.

What is Fee-For-Service?​​​

Fee-For-Service means you or your child are not enrolled in a health care plan. To avoid paying out-of-pocket for health care services, ask your doctor if they take Fee-For-Service Medi-Cal before scheduling visits. 

Who Is Potentially Eligible to Children's Presumptive Eligibility?​​​

Individuals are potentially eligible for Children's Presumptive Eligibility if they are:

  • Under the age of 19
  • A California resident
  • Not already enrolled in Medi-Cal
  • Within the income limits for their household size, and
  • Have not exceeded two Presumptive Eligibility enrollment periods in the last 12 months.

Who Will Help Enroll Me into Children's Presumptive Eligibility?​​​

To apply for Children's Presumptive Eligibility, you must visit a provider who participates, known as a “Qualified Provider."

You can find a Qualified Provider from this list:

Children's Presumptive Eligibility applications are only accepted when trained staff are available during the health care visit. Please call ahead to schedule an appointment.

Resources

​Ways to Apply for Medi-Cal and other Health Coverage Programs​

You can apply for Medi-Cal:

  • Online on Covered California or BenefitsCal.
  • By phone with Covered California at (800) 300-1506
  • By phone with your county social service agency.
  • In Person – contact Covered California at (800) 300-1506 for a list of offices.
  • In Person – find a county social service agency office.
  • ​Download and print a Covered California Application:
    • Fax to (888) 329-3700
    • Mail to 
      • Covered California
      • P.O. Box 989725
      • West Sacramento, CA 95798​

Need help? Get in-person help!​​

Click here to find a Health Enrollment Navigator who can help you apply for health insurance coverage. 

Questions​​

We cannot answer questions related to your Medi-Cal eligibility or look up your case, but we can let you know if a specific location participates in Children's Presumptive Eligibility and answer general questions.

For general questions please e-mail ChildrenPE@dhcs.ca.gov.​

Last modified date: 3/17/2025 11:21 AM