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California Medicaid Expansion
Medicaid Expansion:
California is fully participating in the Medicaid Expansion under provisions of the Affordable Care Act (ACA).
 
For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.

 
Medicaid in California:
The CA Department of Health Care Services administers the state’s Medicaid program, called Medi-Cal.

Information about Medi-Cal, including beneficiary information, can be found at: http://www.medi-cal.ca.gov/.

Provider Participation:
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services. Information about enrolling in the Medicaid fee-for-service program can be found at: http://www.medi-cal.ca.gov/.
The Medicaid website provides information about services covered by fee-for-service payments and payment amounts: http://www.medi-cal.ca.gov/.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.

 
Medicaid Managed Care:
Some Medi-Cal beneficiaries are enrolled in managed care plans. Basic information about the programs, called Medi-Cal Managed Care, can be found at: http://www.dhcs.ca.gov/services/Pages/Medi-CalManagedCare.aspx.
Some managed care plans cover individual California counties and independent cities. The Medicaid website has jurisdictional information: http://www.medi-cal.ca.gov/.

Medi-Cal Beneficiaries Participating in Managed Care:
Managed care plans participating in Medi-Cal Managed Care offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.


Reporting Problems:


The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office: 

916-449-5000

Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies. 

Managed Care Plans Participating in Medi-Cal Managed Care Division:
This list is being routinely updated, and may change as insurers join or leave the Exchange. Please check back for updates.

Alameda Alliance for Health
 
AltaMed (PACE)
 
Anthem Blue Cross Partnership Plan
 
Brandman Centers for Senior Care
 
CalOptima
 
CalViva Health
 
Care 1st Partner Plan, LLS
 
CenCal Health
 
Center for Elders Independence (PACE)
 
Central CA Alliance for Health
 
Community Health Group Partnership Plan
Plan Website: http://www.chgsd.com/
 
Contra Costa Health Plan
 
Family Mosaic Project
Plan Website: Not available
Provider Enrollment: Not available
 
Gold Coast Health Plan
 
Health Net Community Solutions, Inc.
 
Health Plan of San Joaquin
 
Health Plan of San Mateo
Plan Website: http://www.hpsm.org/
 
Inland Empire Health Plan
Plan Website: https://ww2.iehp.org/
 
Kaiser Permanente
Provider Enrollment: Not applicable
 
Kern Family Health Care
 
LA Care Health Plan
 
Molina Healthcare of CA Partner Plan, Inc.
 
On Lok Lifeways
Plan Website: http://www.onlok.org/
 
Partnership Health Plan of CA
 
Positive Healthcare
 
San Francisco Health Plan
Plan Website: http://www.sfhp.org/
 
Santa Clara Family Health Plan
Plan Website: http://www.scfhp.com/
 
SCAN Health Plan
 
St. Pauls PACE
 
Sutter Senior Care (PACE)
 
 
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