N of the health access programs family pact program client eligibility certification cec form 2014-2025

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Scope of Services Family planning services include all contraceptive methods, fertility awareness, female and male sterilization and include specified reproductive health screening tests. Family planning-related services include treatment of specified sexually transmitted infections (STIs).
An activated HAP card offers access to program-specific medical, laboratory and pharmacy services by referral from their physician.
MCAP is for middle-income families who do not have health insurance and whose income is too high for no-cost Medi-Cal. MCAP is also available to individuals who have other health insurance plans that doesnt cover maternity services or with a maternity-only deductible or copayment greater than $500.
The medical director, Medical Doctor (MD), Certified Nurse Practitioner (CNP), or Certified Nurse Midwife (CNM) responsible for overseeing the family planning services to be rendered at the site establishing enrollment is eligible to certify the site. Site certifiers shall sign a statement of affirming responsibility.
Income Eligibility Guideline by Income and Family/Household Size Number of Persons in Family/HouseholdMonthly IncomeAnnual Income 1 $2,608 $31,300 2 $3,525 $42,300 3 $4,442 $53,300 4 $5,358 $64,3005 more rows
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Your income must be at or below 200 percent of the federal poverty income guidelines. This is based on the basic family unit.

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