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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What can I do if I do not like something my Medi-Cal managed care plan did?
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. First, it is always best to talk directly with your provider or call your plan’s customer service number. If that does not resolve the issue, you can take one of the following actions. For more information about the new federal regulations, you can read the National Health Law Pr
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.
Federal funding for the California Community Transitions (CCT) program and spousal impoverishment expansion has ended effective December 31, 2018. Funding may become available again, depending on federal legislation and whether the state of California is able to continue the programs. Check DRC’s website for more information in the coming months. Spousal impoverishment protections still apply to individuals in nursing facilities and on HCBS waivers. If you are not sure if the protections apply to you, you can contact DRC.