Medi-Cal is partnering with managed care plans (MCPs) to improve access to high-quality, coordinated care. Many of these improvements are already happening. In 2024, some counties will get new Medi-Cal MCPs, and some current MCPs will no longer be available.
Find out if your Medi-Cal managed care plan may change. If it does, you will need to take actions in fall 2023. Even if your Medi-Cal MCP does change, your Medi-Cal benefits will remain the same.
There are NO changes being made to:
- PACE - Program of All-Inclusive Care for the Elderly
- SCAN - Senior Care Action Network Health Plan
- Specialty plans
If your Medi-Cal managed care plan is Kaiser, you will remain with Kaiser.
If your Medi-Cal managed care plan will change in 2024
You will receive information in fall 2023 about actions you may have to take to select a new MCP.
If you do have to change MCP, Medi-Cal is taking steps to increase the chance that your provider would stay the same. Even if you do have to change plans, Medi-Cal and the MCP will strive to ensure continuity of care, especially if you have complex or multiple chronic conditions. Medi-Cal will work with providers and MCPs to provide information and answer your questions.
Again, even if your MCP changes, your eligibility for Medi-Cal and benefits will NOT change.
Why is this happening, and what does it mean for me?
Medi-Cal is requiring all MCPs to:
- Meet new standards of care delivery and quality
- Increase transparency
- Improve accountability
- Ensure you have the care you need
- Support you living a healthy life
What you can expect from your MCP and Medi-Cal benefits:
- Coordinated access to care
- Culturally appropriate care
- Integrated physical and behavioral health care services
- Transparency and access to information
What is Continuity of Care, and what does it mean for me?
Continuity of Care means that you may be able to keep your current Medi-Cal provider, including your primary care doctor, specialist, and - in most cases - therapist, for up to 12 months after you are required to change MCPs if your current MCP is no longer contracted to work with Medi-Cal in your county.
Medi-Cal is requiring all MCPs to offer Continuity of Care if all of the following apply to you:
- Your current MCP is no longer operating in your county, requiring you to change MCPs.
- You want to keep seeing your current Medi-Cal provider, and they do not participate in your new MCP.
- You have seen your current provider at least once during the last 12 months.
- Your current provider is willing to work with your new MCP (i.e., agree on payment and/or rates).
There are several ways to request Continuity of Care:
- Call your new MCP.
- Ask your doctor, therapist, facility, or provider to call your MCP.
- Ask a family member or authorized representative to call your MCP on your behalf.
Where can I get help and more information?
The
Office of the Ombudsman will connect you with the right person to help you resolve a problem. They can also connect you with local resources in your county that can help.
Contact the Ombudsman
Phone (888) 452-8609 (TTY: 711 for California State Relay). Hours Monday through Friday, from 8 a.m. to 5 p.m.