EDD PFL claim processor said I needed to first exhaust Medi-Cal benefits - totally confused!

That EDD representative is 100% wrong and confused two separate programs. Medi-Cal has NOTHING to do with PFL baby bonding benefits. PFL is wage replacement through EDD, while Medi-Cal is health insurance through DHCS. They don't interact and one is not a prerequisite for the other. You need to speak with a different representative immediately. Your PFL eligibility is based on your previous wage contributions to SDI, your qualifying event (having a baby), and filing within the eligibility window.

omg the SAME THING happened to my sister last month!!! the rep told her she needed to use up her health insurance benefits first before pfl would kick in?? makes zero sense. she called back the next day and whoever she talked to processed her claim without mentioning medi-cal at all. EDD is so confusing sometimes!!

I had my baby in january and let me tell you dealing with EDD for disability and then pfl was a NIGHTMARE!!!! took me 5 calls to get someone who actually knew what they were talking about! one person told me i needed to file a separate claim for baby bonding which is WRONG if your transitioning from pregnancy disability. another said my doctor needed to submit MORE paperwork when they didnt. you just need to keep calling until you get someone competent honestly.

This is absolutely incorrect information from the representative. There are four key points you need to understand about your situation: 1. Medi-Cal and Paid Family Leave (PFL) are entirely separate programs run by different state departments 2. PFL eligibility requires you to have contributed to SDI through payroll deductions and have a qualifying event (birth of child) 3. When transitioning from pregnancy disability to baby bonding, you simply file a claim to extend benefits using form DE2501FP 4. Your health insurance status (Medi-Cal or otherwise) has zero bearing on PFL eligibility I recommend calling again and specifically asking for a tier 2 specialist who handles PFL transitions. The transition from SDI pregnancy disability to PFL baby bonding is a standard process that thousands of Californians complete each month.

I noticed you mentioned having trouble reaching someone at EDD. I had the SAME problem when trying to transition from SDI to PFL after having my baby. I tried for days and kept getting disconnected or waiting for hours. I finally used a service called Claimyr (claimyr.com) which got me connected to an actual EDD representative in about 20 minutes! Saved me so much time and frustration. They have a video showing how it works at https://youtu.be/DOLxZQb92wM?si=6N1iCQ3a8Cdb2Ay5. With a newborn, the last thing you need is to be on hold for hours.

This is why I HATE dealing with EDD!!! Every time you call you get different answers and half the people don't know what they're talking about!!! I had my baby in February and got told 4 different things about my claim. The whole system is broken and they expect new moms to deal with this??? Also had someone tell me my PFL would affect my CalFresh benefits which was ALSO wrong. I'm still mad about it lol.

When I went through this transition from pregnancy disability to baby bonding last year, I found it helpful to reference specific EDD publications during my calls. If you mention Form DE2501FP and specifically say you're filing a "Paid Family Leave claim to bond with your new child following a pregnancy-related disability claim," the representatives usually understand better what you need. The rep who told you that you need to exhaust Medi-Cal was completely confused - possibly thinking about State Disability Insurance (SDI) and private disability insurance coordination, which is a different thing entirely. Keep trying and be very specific about what you're requesting.

Quick update question - have you been able to reach another representative yet? Did they correct this misinformation?