Medi-Cal is California’s Medicaid program. Medi-Cal is a public health insurance program that provides needed health care services for individuals with limited income including families with children, seniors, persons with disabilities, individuals in foster care, pregnant women, low-income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS, and other individuals with incomes at or below 138% of the federal poverty level.
Medicare is the federal health insurance program for people who are 65 or older, certain people under age 65 with disabilities, and people with End-Stage Renal Disease.
We base our materials on the law at the time we write them. The law can change at any time. If you have a question about the legal accuracy of the materials, contact us or another legal resource.
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California as of July 1, 2017, is following new federal regulations about how you appeal a decision or dispute about benefits, and about how you bring other matters to the attention of the managed care plan through a grievance.
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I have Medi-Cal managed care. What options do I have if my health plan denies a service?
Most Californians who get Medi-Cal are in managed care through a Medi-Cal health plan. Health plans are also called managed care organizations or health maintenance organizations.
There are a number of different programs in California that can help individuals with disabilities and/or seniors who receive Medi-Cal remain in their homes, or help them return home from a long-term care facility (including hospitals, nursing homes, and other medical facilities). This publication provides an overview of these programs, but if you need assistance getting services, you can contact Disability Rights California toll free at (800) 776-5746 or TTY: (800) 719-5798. You can also visit our website at www.disabilityrightsca.org.