Health Care
Dental Services through Medi-Cal
I. HISTORY OF BENEFITS
Medi-Cal provides dental services for adults and children.
Comprehensive dental services are a mandatory benefit for Medi-Cal beneficiaries under age 21. For adults 21 and over, California has the option of providing Medi-Cal coverage for dental services.1
Know Your Rights at Laguna Honda Hospital
On April 14, 2022, Laguna Honda Hospital lost its ability to get paid by Medi-Cal and Medicare due to quality-of-care violations, although payment continues through September 13, 2022, and there is a possibility of an additional 2 months more of payment. Medi-Cal and Medicare pay for most patient care at LHH (over 90%).
Access to ABA Therapy
Applied Behavioral Analysis is an evidence-based therapy. ABA therapy prevents or lessens the bad effects of behaviors that interfere with learning and social interaction.
Important Changes Coming to Medi-Cal in December 2020 for Many Age 65 or Older and People With Disabilities
This publication identifies changes and updates that advocates need to know about the aged, blind, and disabled FPL Medi-Cal Exapansion starting December of 2020.
What Advocates Need to Know About the Aged, Blind and Disabled FPL Medi-Cal Expansion Starting December 2020
This publication identifies changes and updates that advocates need to know about the aged, blind, and disabled FPL Medi-Cal Exapansion starting December of 2020.
In-Home Supportive Services: Anti-Fraud Activities
IHSS gives services to help you stay at home if you cannot take care of yourself because of your disability. This pub gives you details about what the county does to stop IHSS fraud. An example of IHSS fraud is when a provider bills for services they did not provide for you. This pub tells you what to do if you think the county is not doing it right or is discriminating against you.
Timely Access to Medical Care
California law says that managed care plans must make sure that you receive access to healthcare in a timely manner.
When Can A Student Receive Medication At School
This pub tells you when a school has to give your child needed medication. It tells you what medications a school can give to your child. It tells you who can give your child their medication. It gives you other information about giving your child medication at school.
Private Insurance Appeals Including Independent Medical Review (IMR) for Health Plans under the Authority of the California Department of Managed Health Care (DHCS) or Department of Insurance (DI)
This pub tells you what to do if your insurance will not pay for a service you need. Services are things like behavioral services. It can also be occupational therapy or physical therapy. It tells you how to get help.
Hospital Discharge Rights Advocates’ Brief
This publication tells you about hospital discharge rights. It tells you the state laws that apply to you when you are in a hospital even if you do not have insurance. It tells you about the laws that apply if the hospital takes Medicare and Medi-Cal even if you do not have Medicare, Medi-Cal or insurance. It tells you about your rights if you have Medicare. It tells you about your right to get notice before discharge. It tells you about your appeal rights. The publication gives you resources so you can learn more about your rights.
The California Community Transitions (CCT) Program: A Way for a Nursing Home Resident to Return to the Community
Federal funding for the CCT program stopped. There may be funding in the future. If there is funding, California may start the program again. Check our website in the future to find out if this happened.
Enhanced Discharge Planning Rights for Nursing Facility Residents Under MDS 3.0 Section Q
The Federal Nursing Home Reform Act, or OBRA ’87 (Omnibus Budget Reconciliation Act of 1987), created a set of national minimum set of standards of care and rights for people living in certified nursing facilities.
Your Rights to Choices Counseling and Discharge Planning Under MDS 3.0 Section Q
All nursing facilities receiving Medicare or Medicaid funding must administer an MDS assessment to all nursing facility (NF) residents. The MDS is used to obtain information about a resident’s functional capabilities, identify health problems, and to assist in the development of the individual's care plan, including discharge planning.
California Children's Services - Service Rights and Entitlement Programs Affecting Californians with Disabilities
California Children's Services (CCS) is for children under the age of 21. It is for children with physical disabilities. CCS gives medical services and equipment to children. It is for children in low- and middle-income families. This pub tells you all about CCS. It tells how to get the services. It tells you about CCS services. If you disagree with a CCS decision, the pub tells you what to do.
Using Your Medi-Cal Share of Cost if You are a Nursing Facility Resident
If the Medi-Cal program is paying or your nursing facility care and if you also have income – such as from Social Security benefits – you will have a Medi-Cal share of cost equal to all of your income above $35 a month. “Nursing facility” includes a subacute facility and...
California Children’s Services Whole-Child Model Program
Extra Services for Children and Youth Under The Medi-Cal EPSDT Program
This pub tells you about EPSDT. EPSDT stands for Early and Periodic Screening, Diagnosis, and Treatment. It is a Medi-Cal benefit. Medi-Cal gives health care to people with low income and limited ability to pay for health care. If you are under age 21 and have full-scope Medi-Cal, you get EPSDT. It gives you with a number of health care benefits. This pub tells you about those benefits. It tells you what to do if you are not happy with a Medi-Cal decision.
FACT SHEET: Medicaid/Medi-Cal Cuts Will Hurt Schools and Special Education
This publication tells you how cuts to Medicaid/Medi-Cal affects students. Medicaid/Medi-Cal gives health care to people with low income and limited ability to pay for health care. Cuts can mean more students will be absent from school. It means screening students for hearing and vision problems and other problems may not happen. It means fewer mental health resources for students.
Consumer Information for Complaints about Health Care Professionals, Facilities, and Programs
Sometimes, you may need to complain about health care providers, programs, facilities, or services. This pub has lists of agencies in charge of dealing with your complaint. It has a list of advocacy groups that can help you. It tells you where to find out more about your right to complain.