Members FAQs

​Why are Medi-Cal health plans changing in some counties? 

California is changing Medi-Cal so you can get the care you need to live a healthy life.
In 2024, Medi-Cal health plans must meet new rules for quality, access, accountability, and transparency. This will make sure all our members statewide have access to timely, high-quality care from all health plans.

​Will a change to my Medi-Cal health plan affect my Medi-Cal coverage?

No. Even if your Medi-Cal health plan changes, your Medi-Cal coverage and benefits will stay the same.

How do I know if my Medi-Cal health plan is changing?

Find out if your Medi-Cal health plan will change.

What do I ​​​need to do if I live in a county that is changing Medi-Cal health plans?

Health plan is changing

If Medi-Cal health plans are changing in your county, you may have to choose a new Medi-Cal health plan.

Automatic enrollment

In some counties, you will be automatically enrolled in a Medi-Cal health plan without needing to choose one.

Details for foster care children and youth members

​​How will Medi-Cal tell me about a change to my Medi-Cal health plan?

It depends on the county you live in. Read below for information by county.

Health plan is changing 

Medi-Cal health plan Choice Counties (Geographic Managed Care (GMC), Two-Plan, and Regional counties):

​​If you live in one of the counties listed above and your Medi-Cal health plan is changing, you may get a letter:

• October 2023 - If you are now in a Medi-Cal health plan that will be leaving the county at the end of 2023, your Medi-Cal health plan will mail you a letter to tell you about the Medi-Cal health plan change.
• November and​ December 2023 - Medi-Cal will mail you letters with more details on:
  • New Medi-Cal health plan enrollment 
  • More choices you may have
  If you have to choose a new Medi-Cal health plan: You will get a Choice Packet to choose a new Medi-Cal health plan in your county. You must choose a new Medi-Cal health plan by December 22, 2023. If you don’t choose, you will be automatically enrolled in a new Medi-Cal health plan or in Medi-Cal Fee-For-Service (for example, foster care children or youth members).
• December 2023 - After you choose a new Medi-Cal health plan or are automatically enrolled in a new Medi-Cal health plan, Medi-Cal will mail you a letter with information about your new Medi-Cal health plan.
• January 2024 - Your new Medi-Cal health plan will mail you a welcome packet.​
  

Single-Plan or County-Organized Health System (COHS) counties:​

If you live in a county that is changing to a Single Plan Model county or a county that is changing to a County-Organized Health System (COHS) model, you will be automatically enrolled in the COHS plan, Single Plan, or Kaiser Permanente. 

• October 2023 – If you are now in a Medi-Cal health plan that will be leaving the county at the end of 2023, your Medi-Cal health plan will mail you a letter to tell you about the Medi-Cal health plan change.
• November and December 2023 - Medi-Cal will mail you letters with more details on:
• ​New Medi-Cal health plan enrollment 
• More choices you may have
• December 2023 - Medi-Cal will mail you a letter with information about your automatic enrollment in a new Medi-Cal health plan or Medi-Cal Fee-for-Service (FFS) (for example, foster care children or youth members in Single Plan counties).
• January 2024 - Your new Medi-Cal health plan will mail you a welcome packet.​
  

​Can I keep my doctor? 

If your doctor is in your new Medi-Cal health plan:

The new Medi-Cal health plans in your county may include your doctor. To learn more about your Medi-Cal health plan choices and doctors who work with Medi-Cal health plans, go to: www.healthcareoptions.dhcs.ca.gov​

If your doctor is not in your new Medi-Cal health plan:

• If you have gone to a Medi-Cal doctor in the past 12 months who is not in your new Medi-Cal health plan, you might be able to keep your doctor if you ask your new Medi-Cal health plan for continuity of care.​
  
• Continuity of care means you may be able to keep a Medi-Cal provider for up to 12 months after you join a new Medi-Cal health plan. This includes your primary care doctor (PCP), specialists, physical and occupational therapists, and more. 
• Your doctor may agree to work with your new Medi-Cal health plan. This can last up to 12 months or, in some cases, longer. 
• Continuity of care is important for your health and well-being. (Notice of Additional Information​)
  
• If you want continuity of care, call your new Medi-Cal health plan’s member services once you join the new Medi-Cal health plan.
  
• To learn more about your Medi-Cal health plan choices and doctors who work with Medi-Cal health plans, go to: www.healthcareoptions.dhcs.ca.gov​. 

If you need a new doctor:

If your doctor does not agree to work with your new Medi-Cal health plan, your new Medi-Cal health plan will help you find a new doctor. 

If my M​​​edi-Cal health plan is changing, can I still be in Enhanced Care Management (ECM) and Community Supports between October 2023 and December 31, 2023?

Yes. Members who are in a Medi-Cal health plan now can still be enrolled in ECM and Community Supports in that Medi-Cal health plan until December 31, 2023. ​

​​If I am new to Medi-Cal, can I be enrolled in Enhanced Care Management (ECM) and Community Supports between October 2023 and December 31, 2023? 

It depends. Only Medi-Cal health plans offer ECM and Community Supports. They are not available in Medi-Cal Fee-For-Service (FFS). If you join a Medi-Cal health plan in your county now, you will be enrolled on the first day of the next month. You can access ECM and Community Supports after your enrollment date.

If you join a Medi-Cal health plan that is new in your county starting January 1, 2024, you will stay in Medi-Cal FFS until your new Medi-Cal health plan starts January 1, 2024. You will not get ECM and Community Supports until after the date your new Medi-Cal health plan starts.

To learn more about existing Medi-Cal health plans and new Medi-Cal health plans that start on January 1, 2024, read the ​ list of Medi-Cal MCPs by county​. ​

​​What will change for foster care children and youth?

I live in one of these counties: 

• Butte
• Colusa
• Glenn
• Mariposa
• Nevada
• Placer
• Plumas
• San Benito
• Sierra
• Sutter
• Tehama
• Yuba​
  
• ​Your county is changing to a County Organized Health Systems (COHS) Model. 
• You must enroll in the Medi-Cal health plan in your county. 
• You will get letters from Medi-Cal in November and December to tell you of this change.
• In January, you will get a Welcome Packet from your new Medi-Cal health plan. 
• It is important to choose a primary care provider (PCP). Your new Medi-Cal health plan can help you choose one.
• If you have a PCP now, you should call your new Medi-Cal health plan to make sure that your doctor works with your new Medi-Cal health plan.

I live in one of these counties: 

I live in one of these counties: 

• Alameda
• Contra Costa
• Imperial
• Your county is changing to a Single Plan Model.
• If you are in Fee-For-Service (FFS) Medi-Cal now, you will not get a transition notice in late 2023. It is still voluntary for you to be in a Medi-Cal health plan.
• If you are a voluntary member in a Medi-Cal health plan now that will not be available in the county on January 1, 2024, you will get a letter from that Medi-Cal health plan in October. It will tell you they will not be your Medi-Cal health plan starting in January.
• You will also get letters from Medi-Cal in November and December to tell you of this change.
• o To join a new Medi-Cal health plan, call Medi-Cal Health Care Options (HCO) Monday – Friday, 8 a.m. to 6 p.m. at (800) 430-4263 (TTY: (800) 430-7077). Or go to www.healthcareoptions.dhcs.ca.gov​. 
• ​If you do not choose a new Medi-Cal health plan, you will stay in FFS Medi-Cal. Foster care children and youth members in a Single-Plan county don’t need to enroll in a Medi-Cal health plan until 2025.

Will my Medicare change if I have both Medi-Cal and Medicare (dual eligible)​​​?

No, your Medicare benefits and providers will not change when your Medi-Cal health plan changes

Your Medicare providers: 

• Do not have to be in your Medi-Cal health plan network to keep giving you care; however, they do need to be enrolled Medi-Cal providers.
• Cannot charge you co-pays, co-insurance, and deductibles if you have Medi-Cal.
• Should bill your Medi-Cal health plan for co-pays, co-insurance, and deductibles, even if they are not in the Medi-Cal network.

If you have questions about your Medicare, or Medicare Advantage plan, call 1-800-MEDICARE, or the number on your Medicare Advantage plan member card. ​ Learn Mo​re.

​​Will PACE and SCAN health plans change if my Medi-Cal health plan changes? 

No. Program of All-Inclusive Care for the Elderly (PACE) and Senior Care Action Network (SCAN)​ plans will not change.

Learn how to enroll in a PACE or SCAN health plan.​

What protections are there for American Indian and Alaska Native Members during this change? 

If you have an Indian healthcare provider:

American Indian/Alaska Native (AI/AN) members can get healthcare services from any Indian Health Care provider at any time. 

For help​, contact:

• Member’s Medi-Cal health plan or
  
• Medi-Cal Ombudsman
• Phone: (888) 452-8609 (Call is free.)
• TTY: 711 for California State Relay
• Email: ​MMCDOmbudsmanOffice@dhcs.ca.gov

If you have a Non-Indian healthcare provider: 

AI/AN members getting care from a provider that is not an Indian Health Care provider (IHCP) may be able to keep the same provider if they get continuity of care​​.

Contact your Medi-Cal health plan if you need help with continuity of care​.​

Managed care opt-out 

• AI/AN members can opt out of managed care in some counties. 
• For counties where a member cannot opt out, the member still has a right to be seen by an Indian Health Care Provider (IHCP), even if they are not with the Medi-Cal health plan. 
  
• To learn more:
  
• Notice of Additional Information
• ​Contact Health Care Options
• Phone: (800) 430-4263
• Website: www.healthcareoptions.dhcs.ca.gov

​What do I need to do if I was mailed a yellow envelope with a Medi-Cal renewal form in addition to a letter indicating my Medi-Cal health plan is changing?

Complete your Medi-Cal renewal first. If you don’t complete your renewal by the due date printed on your Medi-Cal renewal form, you could lose your Medi-Cal coverage. Please refer to the “Keep Your Medi-Cal” webpage for information on how to complete your Medi-Cal renewal. 

After completing your Medi-Cal renewal form, please review the Medi-Cal letter about your change in Medi-Cal health plans. As described in the FAQ above (see “How will Medi-Cal tell me about a change to my Medi-Cal health plan?​”), Medi-Cal members will either be automatically enrolled in a new Medi-Cal health plan or have active choice of a new Medi-Cal health plan depending on your county of residence. If you keep your Medi-Cal coverage, you will be enrolled in a new Medi-Cal health plan even if you do not actively choose a plan by the date listed on your My Medi-Cal Choice packet for January, 1 2024 enrollment. ​

Medi-Cal is sending the letters regarding changes in Medi-Cal health plans to individuals who are enrolled and eligible for Medi-Cal at the time of mailing (in November and December 2023). If you lose your Medi-Cal coverage and your coverage is not reinstated before January 1, 2024, you do not need to take action on selecting a Medi-Cal health plan. Please refer to the “Restart Your Coverage​” webpage for more information about your coverage options if you receive notification from Medi-Cal that your coverage has ended.

What is a Medi-Cal managed health plan? 

Learn more about Medi-Cal managed health plan options and benefits.

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

Visit the MCP Contact Us webpage.​​