How Do I apply?
Only enrolled Family PACT providers may determine client eligibility and enroll Family PACT clients in the program. These providers are trained to help fill out the form correctly..
Family PACT providers use a Client Eligibility Certification (CEC) form and a Retroactive Eligibility Certification (REC) form to certify a client eligible for Family PACT benefits. Information reported by the client about health care coverage, family size and income is used by the provider to determine eligibility. The client must meet all of the eligibility criteria outlined in this section.
Retroactive Eligibility Certification: This form is designed to cover family planning expenses that were paid for in the 3 months prior to enrolling in Family PACT. The entire process is handled between the Family PACT client and the Department of Health Care Services (DHCS) Beneficiary Services Center. If you submit a claim for the expenses incurred before you were enrolled in Family PACT, the claim will be denied because you were not eligible.
Your Family PACT provider will determine if you were eligible for Family PACT 3 months prior to enrolling. You will be given a number to call to the Beneficiary Services Center to request a claim packet in the mail. You will then provide an itemized list of services paid for to submit with the claim packet.