Disclaimer: These materials are based on the law at the time we write them. We try to update our materials; however, laws are regularly changing. If you want to make sure the law has not changed, contact us or another legal source.
Both Medicaid (or “Medi-Cal”) and Medicare cover medical equipment and supplies, also known as durable medical equipment (DME). However, Medi-Cal and Medicare have different rules regarding coverage, payment, and appeal rights.
This publication discusses Medi-Cal mental health services available through your county. Each county offers mental health services as part of a county “Mental Health Plan” (MHP). Mental health services offered through your county’s Mental Health Plan are sometimes called “Specialty Mental Health Services” (SMHS). This publication discusses Specialty Mental Health Services (SMHS) for children and youth under age 21.
This publication provides information about California programs that help people with disabilities, including children and seniors, who receive Medi-Cal stay in their home or return home from long-term care facilities like hospitals, nursing homes, and other medical facilities.
You can get mental health services through Medi-Cal. You can get them through fee-for-service or managed care plans. In addition, you can get Medi-Cal mental health services through county mental health plans. This pub tells you about county mental health plan services.
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.
What is the Disabled Adult Child (DAC) Medi-Cal Program? Am I eligible for the DAC Medi-Cal Program? Find the answers to these DAC questions and more in this publication.
This pub tells you about your rights when discharged from a hospital and you have Medi-Cal or Medicare. It tells you what to do if you are not ready to leave the hospital. It tells you about services you can get once home. It tells you what to do if you are homeless. It tells you how to complain about the hospital and where to get help.
Did you know that if you get Medi-Cal and your disability makes it hard for you to communicate, Medi-Cal might pay for communication supports that you need?
This publication and the accompanying worksheets may be used to determine if an individual, couple or an individual in a family may qualify for the ABD FPL Medi-Cal program. The ABD FPL program is a no-share-of-cost, full-scope Medi-Cal Program for people who are over the age of 65, or who have a disability. The worksheets are in the following order:
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...
Medi-Cal is a health insurance program for people with limited income. The Affordable Care Act (ACA) made some helpful changes to Medi-Cal to make more people eligible. The ACA also created health benefit marketplaces (exchanges) to help people get health care coverage if they do not have it already.
Medicaid is a critically important source of health care coverage for veterans with disabilities. Nationwide, approximately 1.75 million veterans need Medicaid. Many of them have traumatic brain injuries, spinal cord injuries, and other disabilities, and are at grave risk if Medicaid is cut.
Since 2011, California has been in the process of moving seniors and people with disabilities (SPDs) with Medi-Cal only and those eligible for both Medicare and Medi-Cal (dual eligible) into Medi-Cal managed care plans (Medi-Cal MCP) instead of traditional, regular, or fee-for-service Medi-Cal.
This pub tells you about appealing a decision by or raising other matters with a Medi-Cal managed health care plan. First talk to your provider or call your plan’s customer service number. If that does not work, this pub tells you about other options. It tells you about using a grievance, filing an appeal or asking the Department of Managed Health Care for help.
This publication tells you about Medi-Cal “continuity of care.” If you have to enroll in a Medi-Cal managed care plan, you may be able to see your regular Medi-Cal health care provider. This is what “continuity of care” means. The publication tells you what to do if you cannot get it.
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.
Medi-Cal managed care health plans have networks of providers. Providers are doctors, pharmacies, clinics, labs, and hospitals. Most of the time, you must use the plan providers. There are times when you can get health care from providers who are not plan providers. They are “out-of-network” providers. This pub tells you when you can use such a provider. If Medi-Cal tells you that you cannot go “out-of- network, the pub tells you what to do.
You can get some mental health services from fee-for-service Medi-Cal or Medi-Cal managed care plans. You can only get certain services from county Mental Health Plans. This publication tells you what services you have to get from the county and about mental health services available from Medi-Cal managed care plans. Managed care is a way to provide and pay for health care. You receive most of your health care from a managed care plan. A managed care plan is an organized network of health care providers that focuses on primary and preventive care. Hospitals, physicians and other health care providers are members of the network. This publication tells you what services you can get. It tells you what to do if you do not agree with the health plan.
Medi-Cal managed care plans have to have providers within a certain time and distance from the patients’ home or “time and distance” standards. Managed care is a way to provide and pay for health care. You receive most of your health care from a managed care plan. A managed care plan is an organized network of health care providers that focuses on primary and preventive care. Hospitals, physicians and other health care providers are members of the network. This publication tells you about the “time and distance” standards for providers. It tells you what to do if your plan does not follow its “time and distance” standards.
This fact sheet explains how to obtain transportation to your medical appointments from your Medi-Cal Managed Care Plan (MCP). The end of this publication discusses how to obtain transportation services if you have Fee-For-Service (FFS) Medi-Cal.