What is Medi-Cal?
Medi-Cal is a public program that provides health care coverage to adults, families, older adults, and people with disabilities who meet the income requirements.
What is Medi-Cal Managed Care?
- Medi-Cal Managed Care provides high quality, accessible, and cost-effective health care through managed care delivery systems.
- Medi-Cal Managed Care contracts for health care services through established networks of organized systems of care, which emphasize primary and preventive care.
- Managed care plans are a cost-effective use of health care resources that improve health care access and assure quality of care.
Who can apply?
- People who live in Los Angeles County;
- People who are a parent, child, adults without children, older adults or disabled;
- People who meet the income guidelines; and
- People under the age of 26 or those 50 and older, regardless of their immigration status
- Beginning January 1, 2024, a new law in California will allow adults ages 26 through 49 to qualify for full-scope Medi-Cal, regardless of immigration status. All other Medi-Cal eligibility rules, including income limits, will still apply.
How much will I pay?
Medi-Cal with L.A. Care is free for families who qualify. There are no monthly premiums or co-pays.
What health plan can I choose?
When you join L.A. Care, you can choose to get your health care from L.A. Care or one of the other excellent Plan Partners we work with to provide Medi-Cal coverage in L.A. County. These include Anthem Blue Cross and Blue Shield of California Promise Health Plan.
Continuity of Care
If you now see providers who are not in the L.A. Care network, in certain cases you may be able to keep seeing them for up to 12 months. If your providers do not join the L.A. Care network by the end of 12 months, you will need to switch to providers in the L.A. Care network. You can continue to see your providers when:
- L.A. Care determines you have an existing relationship with your out-of-network provider. An existing relationship means you saw the out-of-network PCP or specialist at least once during the 12 months prior to the date of your initial enrollment with L.A. Care for a non-emergency visit.
- Your out-of-network provider is willing to accept the higher of L.A. Care's contract rates or Medi-Cal FFS rates.
- Your out-of-network provider meets L.A. Care's applicable professional standards and has no disqualifying quality-of-care issues.
- Your out-of-network provider is a California State Plan approved provider; and
- The provider supplies L.A. Care with relevant treatment information.
Members, their authorized representatives, or providers may make a direct continuity of care request to L.A. Care in writing or by telephone.
At any time, a member may change providers to a provider who is a member of an L.A. Care network.