Know Your Rights: Consumer Health Coverage Info

The Health Consumer Alliance Quality of Care Chart provides valuable information on healthcare providers and facilities, helping consumers make informed decisions about their care. Find out how to use this resource effectively. For valuable resources on quality care please use this link.

Justice in Aging provides a consolidated fact sheet on the basics of durable medical equipment and older adults for California advocates. (Apr. 2016)

Continuity of Care (“COC”) is critical to Medi-Cal beneficiaries in a variety of circumstances. There are a number of laws and policies that govern COC for Medi-Cal beneficiaries, depending on the situation. This fact sheet provides an overview of the laws and regulations that require COC for Medi-Cal beneficiaries.

This webinar was recorded on September 21, 2022. You can watch the recording by clicking the link above or here. The PowerPoint materials from this presentation are available by clicking here.

DHCS partnered with HCA to create a content-rich postcard that provides information and resources to support plan, provider, and stakeholder efforts to serve the needs of the LGBTQIA+ community and provide gender-affirming care. The postcard serves as a valuable resource for those seeking to improve the quality of care provided to this marginalized community and to ensure that they receive the best possible healthcare services.

This fact sheet aims to provide consumers with clear information on accessing behavioral health services during the COVID-19 public health crisis. The sheet contains contact details for critical resources that can be reached in case you need any help or have any issues regarding access to care. Translation: Spanish

The American Kidney Fund (AKF) announced it is ending financial assistance funds for Californians in need. The fact sheets below offer alternative options patients can explore.  Please contact one of our partner programs if you need more information.

Coverage Options Fact Sheet (English)

El American Kidney Fund (AKF) anunció que está terminando con los fondos de asistencia financiera para los californianos en necesidad. Aquí hay algunas opciones alternativas que los pacientes pueden explorar. Puede comunicarse con nuestra programas para que le brinden más información.

Opciones de Cobertura (Español)

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

Use the link above 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. Additional contacts for raising concerns may be found here.  Translation: Español/Spanish.  

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.

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.

Who we are, what we do, and who we help.

Western Center’s Getting and Keeping Health Care Coverage for Low-Income Californians: A Guide for Advocates provides California advocates with the relevant statutes, regulations, and guidance needed to help their clients access health care coverage.

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.

A section by section map of the rules of managed care.

Managed Care in California #2:  Network Adequacy in Covered CA

How to continue receiving services, or continue seeing providers, from another plan when you enroll in a new Covered CA plan.