Access to Care: Presumptive Eligibility

Presumptive Eligibility (PE) provides at least 45 days of guaranteed Medicaid or CHP+ coverage to eligible children and pregnant women while their application is being processed through the county Human Services office for final determination of eligibility. This allows the client to seek health care immediately.

When the application visit includes a pregnant woman, a public health nurse performs a comprehensive prenatal assessment. The nurse educates each woman on the importance of early prenatal care, substances that can harm the mother and fetus, pregnancy danger signs, the importance of folic acid and weight gain in an effort to improve access to first trimester care and to improve birth outcomes. This service is also available to women who do not qualify for regular Medicaid due to citizenship requirements, but are able to receive Emergency Medicaid (EMK) to cover delivery costs.

Once you have Medicaid or CHP+ insurance, the Healthy Communities Program can help you find providers and resources and answer questions about your benefits.