If you’ve been approved for Medi-Cal and are ready to choose a managed health plan, we have provided below Medi-Cal Managed care plan options to help you make a decision. The Medi-Cal plan options available to you depend on where you live (county). You are required to choose a plan within 30 days after approval. See below for details on plans available in your county.
Table of Contents
- What is Managed Care?
- What is Medi-Cal Managed Care?
- How to join a Medi-Cal health plan
- Medi-Cal Managed Care Plan Options
- Medi-Cal Managed Care Plans by County
What is Managed Care?
Managed Care is a term that is used to describe a health insurance plan or health care system that coordinates the provision, quality, and cost of care for its enrolled members.
In general, when you enroll in a managed care plan, you select a regular doctor, called a primary care practitioner (PCP), who will be responsible for coordinating your health care.
Your PCP will refer you to specialists or other health care providers or procedures as necessary.
The Managed care plans pay the health care providers directly, so enrollees do not have to pay out–of–pocket for covered services or submit claim forms for care received from the plan’s network of doctors.
What is Medi-Cal Managed Care?
A Medi-Cal medical plan is a group of doctors, clinics, specialists, pharmacies, and hospitals.
Medi-Cal beneficiaries can choose one plan for the family or choose a different plan for each family member.
When choosing a Medi-Cal medical plan, Medi-Cal beneficiaries must choose one primary care provider (PCP) for the family or a different PCP for each family member.
Medi-Cal medical plans offer 24-hour member services information lines.
Additionally, they also cover emergencies and urgent care while Medi-Cal beneficiaries are temporarily outside the State of California.
Over 80% of the more than 10.6 million Californians on Medi-Cal are enrolled in a managed care plan.
Currently, a total of 24 health plans contract with the Department of Health Care Services (DHCS) to provide Medi-Cal managed care services to beneficiaries.
How to join a Medi-Cal health plan
- You must qualify for Medi-Cal to join a medical plan.
- To join a medical plan, call Health Care Options at 1-800-430-4263. Or you can complete a Medi-Cal Choice Form. You can find the form on the Download forms page.
- You can use your Medi-Cal Benefits Identification Card (BIC) for services through Regular (Fee-for-Service) Medi-Cal until you are a medical plan member.
- Health Care Options will send you a letter telling you that your medical plan has changed.
- Approximately 15 – 45 days after you enroll, your new Health Plan will send you a membership card.
- Take your medical plan member card and BIC card with you when you get all medical services, including pharmacy, x-rays, and office visits.
- While you are waiting for the membership card, keep using the doctors and hospitals you use now.
Medi-Cal Managed Care Plan Options
Here are the 24 Medi-Cal managed care plans and the counties they serve.
The list is in alphabetical order by plan name.
Aetna Better Health of California Plan
The Aetna Better Health of California plan serves Medi-Cal recipients in these counties:
- Sacramento
- San Diego
Alameda Alliance for Health Plan
The Alameda Alliance for Health plan serves Medi-Cal recipients in these counties:
- Alameda Alliance for Health
Anthem Blue Cross Partnership Plan
The Anthem Blue Cross Partnership Plan serves Medi-Cal recipients in these counties:
- Alameda
- Alpine
- Amador
- Butte
- Calaveras
- Colusa
- Contra Costa
- El Dorado
- Fresno
- Glenn
- Inyo
- Kings
- Los Angeles
- Madera
- Mariposa
- Mono
- Nevada
- Placer
- Plumas
- Sacramento
- San Benito
- San Francisco
- Santa Clara
- Sierra
- Sutter
- Tehama
- Tulare
- Tuolumne
- Yuba
Blue Shield of California Promise Health Plan
The Blue Shield of California Promise Health Plan serves Medi-Cal recipients in these counties:
- San Diego
California Health & Wellness Plan
The California Health & Wellness Plan serves Medi-Cal recipients in these counties:
- Alpine
- Amador
- Butte
- Calaveras
- Colusa
- El Dorado
- Glenn
- Inyo
- Mariposa
- Mono
- Nevada
- Placer
- Plumas
- Sierra
- Sutter
- Tehama
- Tuolumne
- Yuba
CalOptima Plan
The CalOptima Plan serves Medi-Cal recipients in these counties:
- Orange
CalViva Health Plan
The CalViva Health Plan serves Medi-Cal recipients in these counties:
- Fresno
- Kings
- Madera
CenCal Health Plan
The CenCal Health Plan serves Medi-Cal recipients in these counties:
- San Luis Obispo
- Santa Barbara
Central California Alliance for Health Plan
The Central California Alliance for Health Plan serves Medi-Cal recipients in these counties:
- Merced
- Monterey
- Santa Cruz
Community Health Group Partnership Plan
The Community Health Group Partnership Plan serves Medi-Cal recipients in these counties:
- San Diego
Contra Costa Health Plan
The Contra Costa Health Plan serves Medi-Cal recipients in these counties:
- Contra Costa
Gold Coast Health Plan
The Gold Coast Health Plan serves Medi-Cal recipients in these counties:
- Ventura
Health Net Community Solutions, Inc. Plan
The Health Net Community Solutions Plan serves Medi-Cal recipients in these counties:
- Kern
- Los Angeles
- Sacramento
- San Diego
- San Joaquin
- Stanislaus
- Tulare
Health Plan of San Joaquin
The Health Plan of San Joaquin serves Medi-Cal recipients in these counties:
- San Joaquin
- Stanislaus
Health Plan of San Mateo
The Health Plan of San Mateo serves Medi-Cal recipients in these counties:
- San Mateo
Inland Empire Health Plan
The Inland Empire Health Plan serves Medi-Cal recipients in these counties:
- Riverside
- San Bernardino
Kaiser Permanente Plan
The Kaiser Permanente Plan serves Medi-Cal recipients in these counties:
- Sacramento
- San Diego
Kern Family Health Care Plan
The Kern Family Health Care Plan serves Medi-Cal recipients in these counties:
- Kern
L. A. Care Health Plan
The L. A. Care Health Plan Plan serves Medi-Cal recipients in these counties:
- Los Angeles
Molina Healthcare of California Partner Plan, Inc.
The Molina Healthcare of California Partner Plan serves Medi-Cal recipients in these counties:
- Imperial
- Riverside
- Sacramento
- San Bernardino
- San Diego
Partnership Health Plan of California
The Partnership Health Plan of California serves Medi-Cal recipients in these northern California counties:
- Del Norte
- Humboldt
- Lake
- Lassen
- Marin
- Mendocino
- Modoc
- Napa
- Shasta
- Siskiyou
- Solano
- Sonoma
- Trinity
- Yolo
San Francisco Health Plan
The San Francisco Health Plan serves Medi-Cal recipients in these counties:
- San Francisco
Santa Clara Family Health Plan
The Santa Clara Family Health Plan serves Medi-Cal recipients in these counties:
- Santa Clara
UnitedHealthcare Community Plan
The UnitedHealthcare Community Plan serves Medi-Cal recipients in these counties:
- San Diego
What Medi-Cal Plans Cover
When reviewing Medi-Cal managed care plans, it is important to know what services they are required by the Department of Health Care Services (DHCS) to provide.
Some providers go beyond the minimum requirements. However, all providers are at least required to provide the minimum benefits listed below.
All Medi-Cal Managed Care Medical plans include:
- Doctor’s Visits
- Emergency Services
- Hospice/Palliative Services
- Hospitalization
- Maternity/Newborn Services
- Mental/Behavioral Health Services
- Laboratory/Radiology Services
- Preventative Services
- Substance Use
- Pediatric Services
- Telehealth
Medi-Cal Managed Care Plans by County
For a list of Medi-Cal Managed Care Plans by County, website links, and phone numbers, see our post on California Medi-Cal Managed Care Plans by County.
The list is in alphabetical order. Be sure to scroll down to locate your county of residence and see the Medi-Cal health plans available in your county:
Medi-Cal Managed Care Plan Options Summary
We hope this post on Medi-Cal Managed Care Plan Options and enrollment was helpful.
Questions?
If you have further questions about Medi-Cal, please let us know in the comments section below.
Be sure to check out our other articles about Medi-Cal and California Medicaid program, including:
