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MCE Coverage Program

The San Mateo County Medicaid Coverage Expansion (MCE) Program is a health coverage option available at the San Mateo Medical Center main campus and clinics, and Ravenswood Family Health Center. It is NOT an insurance program. It provides a set of health benefits for uninsured adult residents of San Mateo County age 19 and older. MCE participants are covered for emergency and post-stabilization services at any hospital.

MCE is “bridge” program created by the State of California and the Federal Government for individuals who are expected to qualify for expanded Medicaid benefits in 2014, under the new federal health care reform law. On January 1, 2014, individuals enrolled in MCE will be automatically transitioned to full Medi-Cal coverage.

MCE Covered Services

The benefits covered under the San Mateo County MCE include primary care and specialty care, ancillary services such as laboratory and radiology, inpatient hospitalization, mental and substance abuse services, short term skilled nursing (< 30 days), and emergency care and treatment.

Emergency Care is Covered at Any Hospital

MCE will cover emergency and post-stabilization services at any hospital, including hospitals outside of San Mateo County.

Services Not Covered by MCE

The San Mateo County MCE program does not cover cosmetic surgery, bariatric surgery, transplants, pregnancy-related services, family planning, impotence/infertility, non-medically necessary services, long term care for more than 30 days, experimental or investigational treatments or therapies, non-emergent dental, gender reassignment surgery and related hormonal treatment and certain prescriptions such as vitamins, some pain medications and tranquilizers, etc. Some scheduled admissions and day surgeries must be pre-authorized for medical necessity.

What are the Costs for MCE Coverage and Benefits?

MCE participants do not pay coverage fees and do not have co-pays for services and prescriptions.