Getting Health Care Services

PLEASE READ THE FOLLOWING INFORMATION SO YOU WILL KNOW FROM WHOM OR WHAT GROUP OF PROVIDERS HEALTH CARE MAY BE OBTAINED.

You can begin to get health care services on your effective date of enrollment.
Always carry your L.A. Care ID card, Medi-Cal Benefits Identification Card (BIC), and any other health insurance cards you have with you.

Never let anyone else use your BIC or L.A. Care ID card.

New members must choose a primary care provider (PCP) in the L.A. Care network. The L.A. Care network is a group of doctors, hospitals and other providers who work with L.A. Care.
You must choose a PCP within 30 days from the time you become a member in L.A. Care. If you do not choose a PCP, L.A. Care will choose one for you.
You may choose the same PCP or different PCPs for all family members in L.A. Care, as long as the PCP is available.

If you have a doctor you want to keep, or you want to find a new PCP, you can look in the online Provider Directory. It has a list of all PCPs in the L.A. Care network.
The Provider Directory has other information to help you choose a PCP.
If you need a copy of the Provider Directory, call 1-888-839-9909 (TTY: 711) or download a digital copy from the Medi-Cal Member Materials page.

If you cannot get the care you need from a participating provider in the L.A. Care network, your PCP must ask L.A. Care for approval to send you to an out-of-network provider. This is called a referral.
You do not need approval to go to an out-of-network provider to get sensitive services that are described on the Sensitive care page.

Read the rest of this chapter to learn more about PCPs, the Provider Directory and the provider network.

Pharmacy benefits are now administered through the Fee-For-Service (FFS) Medi-Cal Rx program.
To learn more, visit the Medi-Cal Rx website or, go to the Other Medi-Cal programs and services page in this handbook.