CalAIM Long-Term Care Carve-In Member Information
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Medi-Cal coverage of long-term care (LTC) services has been “carved in” (moved) to Medi-Cal managed care plans statewide. This means that Medi-Cal members get their institutional LTC through their Medi-Cal managed care plan instead of through Medi-Cal Fee-For-Service (FFS). This includes LTC services provided in:
- Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)
- ICF/DD-Habilitative (ICF/DD-H)
- ICF/DD-Nursing (ICF/DD-N)
- Skilled Nursing Facilities (SNFs)
- Adult Subacute Care Facilities
- Pediatric Subacute Care Facilities
Medi-Cal managed care plans began covering LTC services provided by SNFs on January 1, 2023. Medi-Cal managed care plans began covering LTC services provided by Subacute Care DHCS-Contracted Facilities and ICF/DD Homes on January 1, 2024.
What is a Medi-Cal Managed Care Plan?
A Medi-Cal managed care plan is a health plan that:
- Works with doctors, hospitals, and other health care providers in your service area to give you health care services
- Gives you the medically necessary Medi-Cal services you need
- Works with you and your providers to coordinate and manage your care
When you are in a Medi-Cal managed care plan, you may still get some services through FFS (“regular”) Medi-Cal instead of through your Medi-Cal managed care. In most counties, these include:
- Certain home and community-based services
- Most Medi-Cal pharmacy services
- Specialty mental health services
- Substance use disorder (SUD) treatment services
- Dental services
If you have Medicare, your Medi-Cal managed care plan can also give you more benefits that Medicare may not cover and can help you access Medicare services such as:
- Transportation to medical appointments
- Durable medical equipment
- Medical supplies
- Community Supports
To learn more about Medi-Cal managed care plan benefits, go to the Health Care Options website.
Where Members Can Go for More Information and Help
You can contact any of the following groups with questions about the LTC Carve-In. All calls are free.
For Questions or Help with Your Medi-Cal Services:
Long-Term Care Ombudsman
- Call (800) 231-4024. The line is available 24 hours a day, 7 days a week (toll free).
- The Long-Term Care Ombudsman helps people who live in a skilled nursing home, intermediate care facility, and subacute care facility with complaints and know their rights and responsibilities.
Medi-Cal Ombudsman Office
- Call (888) 452-8609 (TTY: California State Relay at 711) (toll free), Monday to Friday, 8 a.m. to 5 p.m. PT.
- Or email them at MMCDOmbudsmanOffice@dhcs.ca.gov
- The Ombudsman Office helps people with Medi-Cal use their benefits and understand their rights and responsibilities.
Medicare Medi-Cal Ombudsman Program
- Call (855) 501-3077 (toll free).
- The Medicare Medi-Cal Ombudsman helps people with complaints and issues for both Medicare and Medi-Cal.
For Questions about Medi-Cal:
DHCS Medi-Cal Helpline
- Call (800) 541-5555 (toll free), Monday to Friday, 8 a.m. to 5 p.m. PT.
To Learn More about Health Plan and Provider Choices:
Medi-Cal Health Care Options
- Call (800) 430-4263 (TTY: (800) 430-7077), Monday to Friday, 8 a.m. to 6 p.m.
- Or go to the Health Care Options website.
- Health Care Options helps people with plan choices and doctor or clinic choices.
For ICF/DD Home Members:
To Find Your Local Regional Center:
- Visit the Department of Development Services (DDS) website
- Or call DDS at (833) 421-0061.
The counties served by each Regional Center can be found below:
| Regional Center | Counties |
| Alta California Regional Center | Alpine, Colusa, El Dorado, Nevada, Placer, Sacramento, Sierra, Sutter, Yuba, and Yolo |
| Central Valley Regional Center | Fresno, Kings, Madera, Mariposa, Merced, and Tulare |
| Eastern Lost Angeles Regional Center | Los Angeles (Alhambra, East Los Angeles, Northeast, Whittier) |
| Far Northern Regional Center | Butte, Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, Trinity |
| Frank D. Lanterman Regional Center | Los Angeles (Central, Glendale, Hollywood-Wilshire, Pasadena) |
| Golden Gate Regional Center | Marin, San Mateo, and San Francisco |
| Harbor Regional Center | Los Angeles (Bellflower, Harbor, Long Beach, and Torrance) |
| Inland Regional Center | Riverside and San Bernardino |
| Kern Regional Center | Inyo, Kern, and Mono |
| North Bay Regional Center | Napa, Solano, and Sonoma |
| North Los Angeles County Regional Center | Los Angeles (East Valley, San Fernando, and West Valley) |
| Redwood Coast Regional Center | Del Norte, Humboldt, Lake, and Mendocino |
| Regional Center of East Bay | Alameda and Contra Costa |
| Regional Center of Orange County | Orange County |
| San Andreas Regional Center | Monterey, San Benito, Santa Clara, and Santa Cruz |
| San Diego Regional Center | Imperial and San Diego |
| San Gabriel/Pomona Regional Center | Los Angeles (El Monte, Glendora, Monrovia, and Pomona) |
| South Central Los Angeles Regional Center | Los Angeles (Compton, San Antonio, South, Southeast, and Southwest) |
| Tri-Counties Regional Center | San Luis Obispo, Santa Barbara, and Ventura |
| Valley Mountain Regional Center | Amador, Calaveras, San Joaquin, Stanislaus, and Tuolumne |
| Westside Regional Center | Los Angeles (Inglewood and Santa Monica–West) |