​Presumptive Eligibility for Pregnant Women

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Welcome to the Presumptive Eligibility for Pregnant Women (PE4PW) web site.

The PE4PW program allows Qualified Providers (QPs) to grant immediate, temporary Medi-Cal coverage for ambulatory prenatal care and prescription drugs for conditions related to pregnancy to low-income, pregnant patients, pending their formal Medi-Cal application.

Information For Women Interested In This Program

The PE4PW program is designed for low-income California residents who believe they are pregnant and who do not have Medi-Cal coverage for prenatal care.

  • For information on the PE4PW program, please visit the PE4PW Information Page.
  • To find a Qualified Provider to enroll, please visit the Qualified Providers by County list on the Qualified Provider page.

Presumptive Eligibility for Pregnant Women Program Fact Sheets​​​

Presumptive Eligibility for Pregnant Women (PE4PW) Flexibilities due to COVID-19

Due to the ongoing Public Health Crisis, DHCS is approving immediate enrollment flexibilities for PE Qualified Providers to limit potential exposure to COVID-19.

PE4PW Qualified Providers can utilize telephonic signatures for PE4PW applications, noting in the case file “COVID-19 protocol." If the individual is not experiencing an urgent prenatal care health event which requires immediate care, providers should suggest the individual to apply online using the CoveredCA portal to establish ongoing eligibility for Medi-Cal or Covered California. Providers may also obtain an Authorized Representative form for the PE4PW applicant, allowing an individual acting on behalf of the applicant, to provide the required information to assist with the enrollment of the individual in PE4PW, thereby minimizing direct contact with the individual and promoting physical distancing.

Process

In order to accept a telephonic signature, the following procedure must be followed:

1. Read the consent language aloud to the individual/Authorized Representative as it is stated on the signature page of the PE4PW Application:

By signing, I declare that what I say below is true and correct.

  • I have read and understood this PE Medi-Cal Application.
  • The information I provided is true, correct, and complete.
  • I understand that I must complete and submit the insurance affordability application by the end of my PE period in order to be eligible for continued coverage.
  • I have received the insurance affordability application.

2. Ask that the individual/Authorized Representative to verbally acknowledge their consent

3. In the signature line, type “Verbal consent – COVID-19"

4. Be sure to document and keep documentation for all verbal consent obtained

Questions

Questions concerning PE4pw Flexibilities should be sent to PE@dhcs.ca.gov.

Last modified date: 4/16/2020 4:41 PM