Medi-Cal is a program that offers health coverage for children and adults with limited income and resources.Ìý
There are two common ways to receive Medi-Cal benefits:
- Medi-Cal which is administered directly by the State. This is usually referred to as Medi-Cal Fee-For-Service (FFS) or traditional Medi-Cal.
- Medi-Cal benefits which are administered by a third-party insurance plan that your county has chosen to administer those benefits for its residents. This is referred to as Medi-Cal HMO or Managed Medi-Cal.
Typically, once you sign up for Medi-Cal, you are enrolled in a traditional Medi-Cal FFS plan for the first 30 days, and then the state transitions you to one of theÌý.ÌýMost counties in California are now using Managed Medi-Cal plans.
Medi-Cal HMO or Managed Medi-Cal Plan Options
À¶Ý®ÊÓƵ is in-network with the following Medi-Cal options.
À¶Ý®ÊÓƵ accepts Medi-Cal Fee-For-Service for hospital and physician services.
À¶Ý®ÊÓƵ is in-network for hospital andÌýspecialist physician services only. You would not be able to select a À¶Ý®ÊÓƵ physician as your primary care physician.
To be seen at À¶Ý®ÊÓƵ, your primary care physician would need to refer you and your medical group or health plan would need to authorize all services provided at À¶Ý®ÊÓƵ or by À¶Ý®ÊÓƵ physicians.
À¶Ý®ÊÓƵ is in-network for hospital andÌýspecialist physician services only. You would not be able to select a À¶Ý®ÊÓƵ physician as your primary care physician.
To be seen at À¶Ý®ÊÓƵ, your primary care physician would need to refer you and your medical group or health plan would need to authorize all services provided at À¶Ý®ÊÓƵ or by À¶Ý®ÊÓƵ physicians.
À¶Ý®ÊÓƵ is in-network for hospital andÌýspecialist physician services only. You would not be able to select a À¶Ý®ÊÓƵ physician as your primary care physician.
To be seen at À¶Ý®ÊÓƵ, your primary care physician would need to refer you and your medical group or health plan would need to authorize all services provided at À¶Ý®ÊÓƵ or by À¶Ý®ÊÓƵ physicians.
À¶Ý®ÊÓƵ is in-network for hospital andÌýspecialist physician servicesÌýonly. You would not be able to select a À¶Ý®ÊÓƵ physician as your primary care physician.
To be seen at À¶Ý®ÊÓƵ, your primary care physician would need to refer you, and your medical group or health plan would need to authorize all services provided at À¶Ý®ÊÓƵ or by À¶Ý®ÊÓƵ physicians.
À¶Ý®ÊÓƵ is in-network for hospital andÌýspecialist physician servicesÌýonly. You would not be able to select a À¶Ý®ÊÓƵ physician as your primary care physician.
To be seen at À¶Ý®ÊÓƵ, your primary care physician would need to refer you and your medical group or health plan would need to authorize all services provided at À¶Ý®ÊÓƵ or by À¶Ý®ÊÓƵ physicians.
All Other Managed Medi-Cal Plans (including Medicaid plans from other states)
If your Medi-Cal plan is not included on the list of in-network plans, that means that À¶Ý®ÊÓƵ does not have a contract with your plan. Some Medi-Cal/Medicaid plans are willing to authorize treatment on a case-by-case basis. It is recommended that you work with your primary care physician to obtain a referral/authorization for treatment at À¶Ý®ÊÓƵ. Once your health plan has authorized the care, they will reach out to À¶Ý®ÊÓƵ to negotiate a single case agreement with our Managed Care Department.
Patient Rights and Protections
Assess Your Coverage
Determine the extent of your coverage or any out-of-pocket costs before you receive care.
Contact: Financial Counseling
Phone: 844-498-2900
Mon. – Fri., 8 a.m. – 5 p.m.
Insurance Pre-Authorization
Find out if your insurance carrier has pre-authorized a medical service before you receive care.
Contact: Financial Clearance
Phone: 650-724-4445
Toll Free: 1-877-291-7335