California § 14005.22 - A pregnant individual is eligible for full-scope Medi-Cal benefits under Section

§ 14005.22. A pregnant individual is eligible for full-scope Medi-Cal benefits under Section

(a) A pregnant individual is eligible for full-scope Medi-Cal benefits under Section 435.116(d)(2) of Title 42 of the Code of Federal Regulations if their income is less than or equal to 109 percent of the federal poverty level, and, effective January 1, 2022, less than or equal to 208 percent of the federal poverty level before the application of the 5-percent income disregard pursuant to subdivision (b) of Section 14005.64, as determined, counted, and valued in accordance with the requirements of Section 1396a(e)(14) of Title 42 of the United States Code, as added by the federal Patient Protection and Affordable Care Act (Public Law 111-148) and as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152) and any subsequent amendments, and the individual meets all other eligibility requirements. (b) To the extent permitted by state and federal law, an individual eligible under this section shall be required to enroll in a Medi-Cal managed care health plan in those counties in which a Medi-Cal managed care health plan is available. (c) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations are adopted. (d) This section shall be implemented only if and to the extent that federal financial participation is available and any necessary federal approvals have been obtained.