Services available for your baby through the DHCS Medi-Cal Managed Care Delivery System
Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care, if medically necessary. For a majority of enrollees, Medi-Cal provides covered services through the managed care delivery system in all 58 counties, although services may be accessed on a fee-for-service basis.
The Affordable Care Act (ACA) ensures all Medi-Cal health plans offer a comprehensive package of services, known as Essential Health Benefits (EHB). The ten EHBs include the following categories of services: Ambulatory Patient Services; Emergency Services; Hospitalization; Maternity and Newborn Care; Mental Health and Substance Use Disorder Services including Behavioral Health Treatment, Prescription Drugs; Rehabilitative and Habilitative Services and Devices; Laboratory Services; Preventive and Wellness Services & Chronic Disease Management and Pediatric Services (including oral and vision care). Medi-Cal currently meets the requirements to cover all of the ten EHBs.
Beginning in 2014, all enrolled individuals, those already on Medi-Cal as well as newly eligible adults, may receive an expanded array of mental health and substance use disorder services. The following mental health benefits will be available through Medi-Cal managed care plans or the fee-for-service delivery system: Individual and group mental health evaluation and treatment (psychotherapy); Psychological testing when clinically indicated to evaluate a mental health condition; Outpatient services for the purposes of monitoring drug therapy; Outpatient laboratory, drugs, supplies and supplements; Psychiatric consultation; Specialty mental health services currently provided by County Mental Health Plans will continue to be available.
The following substance use disorder services will also be made available to eligible Medi-Cal beneficiaries: Voluntary Inpatient Detoxification; Intensive Outpatient Treatment Services; Residential Treatment Services; Outpatient Drug Free Services and Narcotic Treatment Services. Dental care and vision services are available with some limitation. Dental services will become available to all adults starting May, 2014.
For information on the Provisional Postpartum Care Extension (PPCE), an extension of coverage for Medi-Cal or Medi-Cal Access Program (MCAP) eligible individuals diagnosed with a maternal mental health condition (including but not limited to postpartum depression) please visit our PPCE webpage.
Our telephone number is 1-800-433-2611. You can call Monday - Friday, 8 a.m. to 7 p.m. and Saturday, 8 a.m. to 12 p.m. The call is free.
Our fax number is 1-888-889-9238 and is available 24 hours a day, 7 days a week. The call is free.
Medi-Cal Access Program
P.O. Box 15559
Sacramento, CA 95852-0559
Our mailing address for payments is:
Medi-Cal Access Program
P.O. Box 7197
Pasadena, CA 91109-7197