孕产妇及围产期保健服务
卫生保健服务部 (DHCS) 负责监督 Medi-Cal 计划 (Medi-Cal),该计划以按服务收费 (FFS) 和管理式医疗服务体系的形式提供医疗保健服务。
Medi-Cal 涵盖了全面的、适合文化和语言的产妇保健服务和支持。
- 核心怀孕相关服务旨在支持从受孕到产后的孕妇和产后个体的独特需求。 它们包括但不限于标准产科服务(例如,医生访问)、流产、堕胎、免疫接种、处方、实验室服务、助产士或助产服务以及住院护理。
- 这些服务可通过已注册的 Medi-Cal FFS 提供商为 Medi-Cal FFS 成员提供,并通过 Medi-Cal 管理式医疗计划 (MCP) 为接受管理式医疗的 Medi-Cal 成员提供,符合 Medi-Cal 政策。
- Medi-Cal 还涵盖支持孕妇和产后会员的其他服务,包括但不限于:行为健康(心理健康和药物使用)服务和治疗;分娩和育儿健康教育;母乳喂养和营养支持;等等。
- 请咨询您的 Medi-Cal 提供商或 Medi-Cal MCP,了解您是否有资格获得这些服务。 请注意,其中一些服务可能需要额外的批准。 如果是的话,您的 Medi-Cal 提供商或 Medi-Cal MCP 将为您提供帮助。
会员资源
DHCS wants to ensure that Medi-Cal members can understand, navigate, access, and receive comprehensive health care and services.
Medi-Cal members can choose maternal health care and support services that are sensitive to cultural and linguistic needs as well as individual Medi-Cal member preferences in terms of the time, place, and manner of the birthing experience.
An example of some of the Medi-Cal maternal health care services are listed below:
- 助产服务
- 导乐士
- 综合围产期服务计划(DHCS)
- Comprehensive Perinatal Services Program (CDPH-CPSP)
In addition to core pregnancy-related services and other services to support pregnant and postpartum members, many Medi-Cal members who receive services through Medi-Cal MCPs may also be eligible for Community Supports, which are services that help address health-related social needs. These include help getting and maintaining housing, healthy meals, and other community-based services. Members can learn more about Community Supports services offered in their county using the Community Supports Search Tool and contact their Medi-Cal MCP to see if they are eligible.
Further, American Indian women in select counties can get health care, education, emotional support and home visits from trained clinic staff during pregnancy and for the first year of their child’s life. For more information, visit the American Indian Maternal Support Services (AIMSS) program.
其他资源
Medi-Cal 会员还可能有资格通过其他州和合作伙伴服务获得额外的关键支持:
- 妇女、婴儿和儿童 (WIC) 和 CalFresh :有兴趣获得健康营养食品支持的会员应访问WIC和CalFresh 。
带薪家庭假:有兴趣了解怀孕或产后带薪休假权利的会员应访问带薪家庭假以获取更多信息。 - Black Infant Health Program: Some Members who identify as Black women and who are interested in support with life planning, goal setting, and referrals to services can enroll in The Black Infant Health program, which takes a group- based approach where participants get to meet, interact and build a sisterhood with other Black women.
儿童和青少年的 Medi-Cal
After a Medi-Cal member’s child is born, Medi-Cal for Kids & Teens provides free health care services to keep children healthy from birth to age 21. These services include check-ups, shots, and health screenings and treatment for physical, mental, and dental health problems.
获取护理
Medi-Cal FFS members who need maternal health care services should talk to their health care provider or call the Medi-Cal member helpline at (800) 541-5555 or TDD at (800) 430-7077. Medi-Cal members may also review the myMedi-Cal brochure and other information available online.
Medi-Cal members in a Medi-Cal MCP can find general Medi-Cal MCP contact information in the Medi-Cal Managed Care Health Plan Directory or call their assigned Medi-Cal MCP. The phone number for each Medi-Cal member’s assigned Medi-Cal MCP is on their plan ID card. Medi-Cal members in an MCP can find a provider on the Medi- Cal Managed Care website.
Medi-Cal 注册途径
DHCS 和全保加州 (Covered California) 合作创建了单一简化申请,以提供平价医疗保险。 个人可以使用单一简化申请来申请一系列负担得起的医疗保险选项,包括免费或低成本的 Medi-Cal。 申请流程可以通过在线、亲自、电话、传真或邮寄方式完成。
The Single Streamlined Application is available in English and additional languages. Individuals can go to Covered California to complete an online application for Medi-Cal or low-cost health insurance. Alternatively, individuals can print and fill out the Single Streamlined Application, which is available on the DHCS website in English and additional languages and may be mailed to Covered California at the following address:
Covered California
P.O. Box 989725
West Sacramento, CA 95798-9725
Alternatively, the Single Streamlined Application can also be mailed to an individual’s local county office.
For more information on Medi-Cal enrollment, please also review the information available on DHCS’ website.
提供商资源
DHCS 还为 Medi-Cal 提供商创建了各种 Medi-Cal 资源和材料,包括但不限于:
- Medi-Cal 提供者手册:这份综合性文件包含 Medi-Cal FFS 和管理式医疗的覆盖政策以及 Medi-Cal FFS 计费和报销要求。
- 所有计划和政策信函:除了 Medi-Cal 提供商手册中包含的覆盖政策信息之外,这些文件还提供了针对 Medi-Cal MCP 的额外指导,包括但不限于与管理式医疗特定合同要求相关的提醒以及影响 Medi-Cal MCP 运营方式和/或向 Medi-Cal 成员提供服务的方式的联邦或州法规和法规的变化。
- Medi-Cal 学习门户 : This resource offers Medi-Cal providers and billers self-paced online training about billing basics, policies, procedures, new initiatives, and upcoming changes to Medi-Cal. To register or login, Medi-Cal providers and billers can go to Medi-Cal’s Learning Portal webpage to view or search the online course catalog.