MedicaidCoverageHigh impact
22-186 Medi-Cal Postpartum Coverage Now Extends to 12 Months
Health Net·CA · OB-GYN, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
Medi-Cal postpartum coverage has been extended from 60 days to 12 months (one full year) after delivery for all pregnancy-related and postpartum care services. This expansion applies to all Medi-Cal members in Fresno, Kings, and Madera counties regardless of citizenship status or income changes.
Action Required
Immediately: Billing team must update eligibility verification processes to check for extended 12-month postpartum Medi-Cal coverage instead of the previous 60-day limit. Update billing system rules to recognize coverage extends to the last day of the month in which the 365th day after delivery occurs. Train front desk staff to verify eligibility for postpartum members up to one year after delivery for pregnancy-related services.