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/
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/.
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 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.
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:
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
Anthem Blue Cross Partnership Plan
Brandman Centers for Senior Care
Care 1st Partner Plan, LLS
Center for Elders Independence (PACE)
Central CA Alliance for Health
Community Health Group Partnership Plan
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
Inland Empire Health Plan
Provider Enrollment: Not applicable
Kern Family Health Care
LA Care Health Plan
Molina Healthcare of CA Partner Plan, Inc.
On Lok Lifeways
Partnership Health Plan of CA
San Francisco Health Plan
Santa Clara Family Health Plan
SCAN Health Plan
St. Pauls PACE
Sutter Senior Care (PACE)