This program is administered
by the Managed Risk Medical Insurance Board (MRMIB).
Welcome to AIM
To have a healthy baby — One of the best things you can do is see a doctor early and often.
What is Medi-Cal Access Program?
The Medi-Cal Access Program provides pregnant women with comprehensive coverage for a low cost with no copayments or deductibles for its covered services. Their newborns may be covered by the Medi-Cal Access Infant Program. Medi-Cal Access Program is for middle-income families who do not have health insurance and whose income is too high for no-cost Medi-Cal. Medi-Cal Access Program is also available to women who have other health insurance plans that doesn’t cover maternity services or with a maternity-only deductible or copayment greater than $500. You can read more about Coordination of Benefits between your other health insurance plan and the Medi-Cal Access Program health plan in the Glossary of Terms. If you are enrolled in Medi-Cal Access Program, your baby is eligible for coverage in the Medi-Cal Access Infant Program for up to two years, unless your baby is enrolled in employer sponsored insurance or no-cost Medi-Cal or your income no longer qualifies at your infant’s first birthday.
Services available for your baby through the DHCS Medi-Cal Health Care Delivery System
Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care, if medically necessary. For a majority of enrollees, Medi-Cal provides covered services through the managed care delivery system in all 58 counties, although services may be accessed on a fee-for-service basis.
The Affordable Care Act (ACA) ensures all Medi-Cal health plans offer a comprehensive package of services, known as Essential Health Benefits (EHB). The ten EHBs include the following categories of services: Ambulatory Patient Services; Emergency Services; Hospitalization; Maternity and Newborn Care; Mental Health and Substance Use Disorder Services including Behavioral Health Treatment, Prescription Drugs; Rehabilitative and Habilitative Services and Devices; Laboratory Services; Preventive and Wellness Services & Chronic Disease Management and Pediatric Services (including oral and vision care). Medi-Cal currently meets the requirements to cover all of the ten EHBs.
Beginning in 2014, all enrolled individuals, those already on Medi-Cal as well as newly eligible adults, may receive an expanded array of mental health and substance use disorder services. The following mental health benefits will be available through Medi-Cal managed care plans or the fee-for-service delivery system: Individual and group mental health evaluation and treatment (psychotherapy); Psychological testing when clinically indicated to evaluate a mental health condition; Outpatient services for the purposes of monitoring drug therapy; Outpatient laboratory, drugs, supplies and supplements; Psychiatric consultation; Specialty mental health services currently provided by County Mental Health Plans will continue to be available.
The following substance use disorder services will also be made available to eligible Medi-Cal beneficiaries: Voluntary Inpatient Detoxification; Intensive Outpatient Treatment Services; Residential Treatment Services; Outpatient Drug Free Services and Narcotic Treatment Services. Dental care and vision services are available with some limitation. Dental services will become available to all adults starting May, 2014.