Know Your Rights: Consumer Health Coverage Info

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 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.

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.

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)

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.