Costs

Member Costs

L.A. Care serves people who qualify for Medi-Cal. In most cases, L.A. Care members do not have to pay for covered services, premiums or deductibles.

Except for emergency care, urgent care or sensitive care, you must get pre-approval from L.A. Care before you see a provider outside the L.A. Care network.
If you do not get pre-approval and you go to a provider outside of the network for care that is not emergency care, urgent care or sensitive care, you may have to pay for care from providers who are out of the network.

For a list of covered services, go to What your Health Plan Covers in this online handbook.

For members with long term care and a share of cost

  • You may have to pay a share of cost each month for your long-term care services.
  • The amount of your share of cost depends on your income and resources. Each month you will pay your own medical bills, including but not limited to Managed Long Term Support Service (MLTSS) bills, until the amount that you have paid equals your share of cost. After that, your long-term care will be covered by L.A. Care for that month.
  • You will not be covered by L.A. Care until you have paid your entire long-term care share of cost for the month.
     
  • How a Provider Gets Paid
  • Provider Incentive Programs
  • Asking L.A. Care to Pay a Bill
  • Asking L.A. Care to Pay You Back for Expenses