Webinar: Health Coverage Conversations: Helping Families Understand Their Options
Navigating health coverage programs can be challenging, especially for new and expectant parents. With the complexities of Medi-Cal and continual policy changes and updates, families can fall through the cracks at a time when support matters most. Hospital Liaisons in the Welcome Baby program can play a crucial role in helping families understand their options, access benefits, and stay connected to care.
In an LA Best Babies Network-hosted webinar on November 6, 2025 — for Hospital Liaisons and other staff of our network’s home visiting organizations and Welcome Baby hospitals — Liz Ramirez, Director of Training and Education at Maternal and Child Health Access, discussed:
- Policy changes impacting Medi-Cal eligibility and coverage
- Health coverage programs for pregnant individuals in Los Angeles County
- Strategies to identify and address common newborn enrollment issues impacting patients/clients
- Tools to more effectively advocate for communities
What Is Medi-Cal?
Medi-Cal is California’s version of Medicaid, the federal program that provides health coverage for low-income individuals and families. While Medicaid is federally funded, California contributes state dollars to expand benefits beyond what the federal government requires.
Medi-Cal helps cover a wide range of health services, including preventive care, hospital and doctor visits, and, uniquely in California, additional benefits like preventive dental care and glasses for adults. California also provides coverage through Medi-Cal for eligible immigrant residents.
Medi-Cal Eligibility: California Residency
To qualify for Medi-Cal, you must be considered a California resident, which means:
- You live in California and intend to remain living in the state, or
- You live and work in California, or intend to work in the state
Medi-Cal Serves Different Populations
Medi-Cal provides coverage for a variety of groups, each with its own eligibility rules:
- Elderly or disabled adults (65 and older) – coverage tailored to health and long-term care needs
- Children (ages 0–19) – including access to preventive care, check-ups, and treatments
- Pregnant individuals – including prenatal, childbirth, and postpartum care
- Adults under 65 – including those without children, with rules based on income and other factors
Understanding these categories helps families know which program fits their situation and what benefits they can access.
Two Kinds of Medi-Cal
(View the Health Care Countable Monthly Income Comparison Chart for details.)
MAGI Medi-Cal (Modified Adjusted Gross Income Medi-Cal)
- Covers most adults under 65, children, and pregnant individuals (those with Medicare are not eligible)
- Eligibility is based primarily on income and household size
- Uses the federal Modified Adjusted Gross Income (MAGI) rules, which simplify income counting
Non-MAGI Medi-Cal
- Covers elderly adults (65+), people with disabilities, and certain other special populations
- Rules are more complex and vary depending on the program
- Eligibility is based on income and assets, and sometimes on specific medical needs
Medi-Cal Presumptive Eligibility (PE) for Pregnant Individuals
Presumptive Eligibility (PE) provides immediate, temporary coverage for prenatal care to low-income pregnant patients while their formal Medi-Cal application is being processed. This ensures that pregnant individuals can access care without delay.
Who is eligible?
- Any person who thinks they are pregnant
- Family income is under 213% of the Federal Poverty Level (FPL)
Important: Pregnant people enrolled in Presumptive Eligibility (PE) must apply for Medi-Cal for continuation of coverage. PE provides temporary, immediate prenatal care, but ongoing benefits require a completed Medi-Cal application.
For more information, visit the California Department of Health Care Services (DHCS) website.
Medi-Cal Program: Income Disregard for Pregnant Youth Under Age 21
A pregnant individual may qualify for Medi-Cal without counting their parents’ income if they meet all of the following criteria:
- Under age 21
- Living with parents or claimed as a tax dependent by parents
- Parents’ income is not counted for eligibility purposes
All pregnant individuals enrolled in Pregnancy Medi-Cal or the Medi-Cal Access Program (MCAP) are eligible for 12 months of coverage after pregnancy. This ensures ongoing access to health care for both the parent and newborn during the critical postpartum period.
Medi-Cal for Newborns
- No application needed — just notify Medi-Cal of your new baby
- Coverage: Under mother’s Medi-Cal ID for the first month plus the next (up to 60 days)
- Provide: Name, Date of Birth, Gender
Public Charge Concerns
Many families worry that using public programs could affect their immigration status, especially given the current climate of uncertainty. It’s important to know that federally funded Medi-Cal and Food Assistance are not considered Public Charge benefits, so accessing these services will not impact your immigration status or future applications. Learn more here.
Note: An AP news report states that in June 2025, the Centers for Medicare and Medicaid Services (CMS) was directed to share Medicaid enrollee data in some states, including California, with federal Department of Homeland Security (DHS), which includes Immigration and Customs Enforcement (ICE), for immigration enforcement purposes.
Upcoming Changes to Medi-Cal in 2026
Medi-Cal Expansion Freeze: Adults 19 and older without Satisfactory Immigration Status (SIS) will no longer be eligible for expansion coverage.
Asset Limit Returns: Non-MAGI Medi-Cal recipients will be subject to an asset limit: $130,000 for an individual and $65,000 for each additional household member.
More details: DHCS Medi-Cal Changes
Other Health Insurance
Those without Medi-Cal coverage may insure their families through Covered California, the Kaiser Community Health Care Program, and Los Angeles County Health Programs (see slides 56-59 from this webinar).
This webinar was not recorded, but don’t miss the links to related resources below:
About the presenter:
Liz Ramirez is Director of Training and Education for Maternal and Child Health Access. Her work focuses on health policy, benefits of eligibility, and advocacy for clients facing access to care issues in both public and private health systems. Liz led MCHA’s efforts in the Patient Protection and Affordable Care Act implementation in Los Angeles County. She has been committed to issues with health care access for over 27 years.