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About Medi-Cal managed care medical plans
- Medi-Cal wants you and your family to be healthy and satisfied with your health care.
- Medi-Cal managed care medical plans have their own doctors, specialists, clinics, pharmacies, and hospitals.
- You can choose the doctor or clinic for all your health care needs. Medi-Cal managed care medical plans offer special care such as checkups, routine tests for adults, and shots for children and babies that can help you stay healthy.
- You can go to your primary care provider (PCP) first, unless it is an emergency or a family planning visit.
- The medical plan has a member services department or an after-hours number that you can call.
- Eligibility for CalWORKS, Medi-Cal, and Food Stamps
Keeping or changing your medical plan does not change your eligibility for other programs. - Benefits Identification Card (BIC)
The plastic card sent to everyone who qualifies for Medi-Cal. All Medi-Cal providers use the BIC to check eligibility. Also called the Medi-Cal card. - Direct access to women's health services
A woman can go directly to any network provider for women's health care without a referral from another doctor. - Medical second opinions
You can request that another doctor or specialist see you before you make decisions about your doctor's plan for your care or surgery. - You do not have to ask managed care doctors if they take Medi-Cal patients.
How to choose a medical plan
- Think about what is important to you when you get health care.
- Talk to your family, friends and doctor.
- To help you decide which medical plan you want, go to the Compare medical plans and dental plans page.
- Look at the provider directories on the Health plan materials page.
Things to think about before you make your choice:
Doctor
- Am I happy with the doctor I have right now?
- Does my doctor belong to a medical plan?
- Which medical plans is my doctor in?
- Do I have to wait long to get an appointment?
- Are they open when I can go?
- Does the doctor have experience with my child's or my medical problem?
Language
- Does the doctor speak my language or provide interpreters who do?
Location
- Is the doctor’s office or clinic nearby?
- Is it easy to get to?
- Does the medical plan or doctor provide transportation?
How to join a medical 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.
- Your medical plan will send you information about its services and a medical plan member 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.
How to change your medical plan
- If you are not happy with your medical plan, you can choose another medical plan, if available.
- To change your medical plan, call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077). Or you can complete a Medi-Cal Choice Form. You can find the form on the Download forms page.
- Mail the completed choice form.
- Health Care Options will send you a letter. It will tell you that your plan has changed.
- You must see your present doctor until you get the letter from Health Care Options.
Working with your medical plan
- Know how to use your medical plan as soon as you become a member.
- Read all the information your medical plan sends to you.
- Call your medical plan's member services department and ask any questions you have about your medical plan. Member services staff will be glad to help you.
