​​​Medi-Cal Managed Care Plan Contract FAQ for Members​​

​​​Back to ​Information for Medi-Cal ​Members​

​1. What is happening with Medi-Cal managed care plans (MCPs)?

Starting in January 2024, all Medi-Cal plan partners statewide will operate under a new, rigorous managed care contract to provide quality, equitable, comprehensive coverage for Medi-Cal managed care members. This will transform and improve how care is delivered to millions of Californians in the Medi-Cal health system. 

2. ​What does this mean for me and other Medi-Cal members?  

Additional improvements to your Medi-Cal MCPs are expected in 2024. Medi-Cal is partnering with health plans to make sure you and your family have improved access to high-quality and coordinated care. Many of these improvements are already happening (see Question 6 below for more details). 

In 2024, new health plans will be available in some counties, while other health plans will no longer be available. In many counties, there will be no change to MCPs at all in MCPs. Find out if your health plan may chang​e​. 

Some important things do NOT change. For example, there are no changes coming to the Program of All-Inclusive Care for the Elderly (PACE) specialty plans. Also, if your Medi-Cal managed care plan is Kaiser, you will remain with Kaiser. And, we expect members to have no disruption in their pharmacy benefits during this transition because pharmacy benefits are carved out of managed care, and (as of January 1, 2022) are administered by DHCS under Medi-Cal Rx. 

3. ​How will I know if my Medi-Cal managed care plan is changing in 2024? 

Please see the county chart​ to learn if your Medi-Cal managed care plan may change.  

• If your MCP is not changing, there are no additional steps for you to take. Your MCP will remain the same in 2024.  
• If your plan will change in 2024, you will receive information about your plan options in fall 2023.  
  

DHCS is working to ensure that your care, treatments, and services stay the same. DHCS will prioritize your Continuity of Care, especially if you have complex or multiple chronic conditions. We will work with providers, plans, and community-based organizations to provide information and answer your questions (see below for resources). 

​4. What should I do and expect before 2024? What steps do I need to take now?  

The changes discussed here are for 2024 - not for now. You will have your same provider throughout 2023, except for United Healthcare, whose managed care contracts ended on December 31, 2022. 

Members who will need to transition to new plans in 2024 will receive information about your plan options in fall 2023.  The information will explain actions you may have to take regarding your Medi-Cal managed care plan coverage.  We encourage you to make sure your MCP and Medi-Cal office has up-to-date contact information for you and your family. Please contact your current health plan and county social services office to update your contact information. 

​​​5. What is DHCS doing to ensure a smooth and safe transition for members transitioning from an exiting MCP to a new MCP? 

DHCS is working closely with plans and stakeholders to prepare for and help members transitioning from exiting plans to a new MCP. As part of the enhanced contract requirements, DHCS will be able to hold all exiting plans accountable for transitioning its members to MCPs and coordinating the transfer of care. 

6. ​​Why are these changes happening, and what’s in it for me and my family? 

California’s new contract with MCPs establishes new standards of care, increased transparency, and greater accountability to make sure you and your family have the care and support you need to live healthier, more fulfilling lives. While these changes will take time, Medi-Cal members can expect to see changes and additions to their coverage. These include: 

More Coordinat​​ed Access t​​​o Care: 

• Members with complex needs will have access to a designated point person, a care manager, who can assist them—and their families—with navigating the health care system, handling referrals, and supporting communication with providers.  
• Plan partners will be required to coordinate and facilitate referrals to services provided by local health departments, County Behavioral Health P​lans, schools, justice systems, and community-based organizations—and will follow up to ensure that members get the care they need.  
• Members won’t have to worry about a change to their benefits if they move to another county within the state. Every member will have a comprehensive benefit package no matter where they live in California. 
• Because health coverage is only helpful if you can get the care you need, members will have access to a suite of tools to help them obtain the services they need, when they need them. This includes things like interpreter services and telehealth technology for remote visits with their providers.    
  

More Culturally Ap​​propriate C​ar​​e:  

• ​Members will benefit fro​m care and services that take into account their culture, sexual orientation, sex and gender identity, and preferred language. 

Better Behavio​​ral and Physical ​​Health Integration:

• Member physical health care will be better integrated with their behavioral health care, narrowing the divide between the two and improving access to mental health support and substance use disorder treatment.  
• Children, youth, and adults will benefit from earlier diagnoses, engagement, and behavioral health treatment.  
• The “No Wrong Door” for mental health services means that members will receive timely mental health services regardless of where they initially seek care.  

Increased Transpar​​ency and Easy Access t​​o Information: 

• Increased transparency starts well before the point of care. Members will have new and easy access to information that helps them pick the plan that’s right for them. They’ll be able to identify:   
• The providers (doctors, clinics, etc.) that are part of the plan’s network. 
• How much the plan spends on services to keep Medi-Cal members healthy and well, like physicals, immunizations, and health screenings.  
• Member experience and satisfaction based on responses to surveys, so they can see what others think about the plan they’re considering.   

Collaboration and Community​ Supports:  

• The health of any Californian is inextricably linked to the health of their community.  
• Plans must bring health care providers and community organizations together to share information and co-design solutions to deliver quality whole-person care.  
• Plan partners must coordinate services members receive, including those provided by local health departments, county behavioral health plans, schools, justice systems, and community-based organizations. 
  

Impr​​oved​ Equi​​ty​:  

• Racism, bias, and other forms of discrimination have no place in our health care system.  
• Each plan will now be required to have a Chief Health Equity Officer, and to identify and outline steps they are taking to improve health outcomes within the most vulnerable and impacted groups and communities. 
• ​Plans will be required to ensure that members receive culturally appropriate care and dignified and respectful treatment. They will have to continue to participate in a rigorous health equity accreditation program that will help hold them accountable for meeting these standards. 

7. ​​What was the outcome of the commercial MCP procurement? 

The procurement was canceled​. DHCS and five commercial managed care plans – Blue Cross of California Partnership Plan (“Anthem”), Blue Shield of California Promise Health Plan, CHG Foundation d.b.a. Community Health Group Partnership Plan, Health Net Community Solutions, Inc. and Molina Healthcare of California – came to an agreement to deliver Medi-Cal services to Medi-Cal managed care members in 21 counties across the state starting in January 2024.

Beginning in 2024, all Medi-Cal plan partners statewide will operate under the new, rigorous managed care contract to provide quality, equitable, comprehensive coverage for Medi-Cal managed care members. This will transform and improve how care is delivered to millions of Californians in the Medi-Cal health system. 

​8. Where can I get help and more information?  

​Learn More​​​​ About the Agreements​