Conoce tus derechos:
Información de Seguro de Salud del Consumidor

In an updated series of fact sheets called Protect Medicaid Funding, NHeLP provides succinct analysis of the policy proposals that if enacted would jeopardize the health and financial security of the tens of millions of low-income individuals who depend on the Medicaid guarantee every year.

Use this link to access the reference guide for consumers seeking to raise concerns about the quality of their care whether the problem is caused by a provider, plan or facility. Translation: Español/Spanish.  

This is an advocate fact sheet that discusses monitoring plan provisions of mental health services to Medi-Cal beneficiaries.

Federal and state law and the Constitution ensure that enrollees in publicly-funded health care plans receive notice, grievance and appeal rights when they are denied access to medical services. Enrollees in Covered California plans have the right to a notice when their plan denies access to a service and have several avenues to contest the plan’s decision through a grievance or appeal. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not understand their right to appeal the plan’s decision. This fact sheet will describe the legal protections available to consumers in California and how to enforce these rights.

This consumer brochure discusses what a consumer can do if they get a medical bill and do not have health insurance. Translations:  English: What can I do if I get a Medical Bill?   Arabic: أن أفعله ماذا يمكنني إذا وصلتني فاتـورة طبــية؟ Armenian:  ماذا يمكنني أن أفعله إذا وصلتني فاتـورة طبــية؟   Cambodian/Khmer: តើខ្ញុំគួរធ្វើបែបណា បើខ្ញុំទទួលបាន វិក័យប័ត្រពេទ្យ? Korean: 의료청구서를 받으면 어떻게 해야 하나요?     Russian: Что делать, если я получил счет за медицинские услуги? Simplified Chinese/Cantonese: 如果我收到医疗费账单该怎么办? Tagalog: Ano Ang Maari Kong Gawin Kung Makatanggap Ako Ng Singil sa Medikal? Traditional Chinese/Mandarin: 如果我收到醫療費帳單該怎麼辦? Vietnamese: Tôi có thể làm gì nếu tôi nhận được hóa đơn y tế?  

This is a sample letter consumers can use when they go to a Medi-Cal provider for a Medi-Cal covered service and are incorrectly billed for the service.

This consumer brochure explains a Medi-Cal Share of Cost and how you can "meet your share of cost."

Su costo compartido es la cantidad de dinero que debe pagar u obligarse a pagar cada mes por los productos y servicios médicos antes de que Medi-Cal empiece a pagar.

This HCA factsheet address the Early and Periodic Screening, Diagnostic, and Treatment (ESPDT) program and how children access EPSDT services. The fact sheet also addresses other Medi-Cal programs that provide special services to children under 21.

This consumer brochure addresses how to access care through your Medi-Cal managed care plan and your rights if you are not getting the health care you need.

Has Medi-Cal told you No?  You have options! Use the link above to access a valuable resource presented by the Health Consumer Alliance and learn how to make them say Yes!

The National Health Law Program's (NHeLP) experts cover a number of issues impacting access to and the quality of care for low-income and underserved people and families. This issue brief analyzes the legal requirements that require County Medical Health Plans (MHPs) to ensure Medi-Cal beneficiaries’ access to Specialty Mental Health Services (SMHS) and maintain adequate provider networks. It also discusses the different types of enforcement and monitoring tools to hold MHPs accountable.

This Justice in Aging resource discusses what advocates can do to help dual eligible clients who receive medical bills..

This Justice in Aging guide is designed for advocates and individuals who provide assistance to dual eligibles (for both Medi-Cal and Medicare) and seniors and persons with disabilities.

Managed Care in CA #5: Covered California members have the right to a notice when their plan denies access to a service, and there are many ways to challenge the plan’s decision through a grievance or appeal.

How to enroll in a Covered CA health plan outside of the open enrollment period.

California is making major changes to the delivery of Medi-Cal services over the next two years. NHeLP has created a fact sheet briefly outlining some of these upcoming changes to Medi-Cal services in 2023-2024 and discusses important consumer protections that are designed to ensure that beneficiaries maintain access to needed care during these major programmatic transitions. (Jun. 2023)