Medi-Cal Providers, Doctors & Companies

Medi-Cal Providers, Doctors and Companies

Everyone has health care needs, but not everyone has the financial means to seek treatment without access to affordable health insurance coverage — until now. If you need health insurance coverage for yourself or your family, you can now afford medical services at little or no cost thanks to Medi-Cal, California’s Medicaid program. Health for California helps Californians find the ideal coverage depending on their needs.

What Is Medi-Cal, and How Does It Work?

Medi-Cal is California’s Medicaid program, designed to help low-income individuals and families gain access to necessary medical and health care providers and services. The California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS) oversee the program.

Medi-Cal is ideal for those who need financial assistance paying for visits to their primary care physician or dentist, surgeries, hospital stays, prescription medications, rehab treatments and more. Over 400 hospitals and approximately 130,000 physicians, pharmacists, dentists and other health care providers in California participate in the Medi-Cal program.

Most Medi-Cal plans are managed care plans, which means they operate similarly to a Health Maintenance Organization (HMO). You will coordinate care using several Medicaid doctors and companies under this designation. Medi-Cal also offers Fee-For-Service plans.

How to Determine Your Medicaid Provider Network

If you’re eligible to enroll in Medi-Cal, you are automatically placed into the Fee-For-Service plan until you select your managed care provider. Your access to Medi-Care health plans depends on what California county you live in. Once you choose a Medi-Cal managed care plan, you will select your primary care physician (PCP), the main doctor you will see for your routine checkups and visits when you’re sick.

You can view the Medi-Cal Managed Care Health Plan Directory to determine which health plans are available in your county. You must select a plan no more than 30 days after you’ve been informed you qualify for Medi-Cal services. Otherwise, the state of California will choose your health plan for you.

If your county only has one plan listed, that is the only option available for all Medi-Cal enrollees. If multiple options are available, you should compare plans to choose the best one to meet your health and medical needs.

How to Find Medical Providers, Doctors and Hospitals

How do you find the list of medical providers? Once you have selected your health plan, you can determine which providers are covered. You can use the medical physician directory or find a provider on DHCS’ portal, following three simple steps to search by location:

What Health Insurance Companies Are Available in California?

Medi-Cal works with 11 different health insurance companies throughout California that provide individual, family and group health insurance. Those companies include:

• Anthem Blue Cross: Anthem Blue Cross has grown its membership in California to about 8.6 million members. Its network includes over 60,000 care providers with coverage in many regions.
• Blue Shield of California: Blue Shield of California is based in San Francisco and provides plans for all California counties and ZIP codes and serves over 4 million members.
• Chinese Community Health Plan (CCHP): CCHP is a non-profit health plan with an integrated delivery system and over 27,000 members. It partners with 10 hospitals, several clinics and over 300 neighborhood physicians in the Bay Area.
• Health Net: Health Net provides health care coverage to millions of members in California and has many networks in the state. The company is committed to improving health through preventive care.
• Kaiser Permanente: As the oldest and largest HMO in the country, Kaiser Permanente has its largest membership base in California. The company offers Covered California plans in all 19 pricing regions in the state.
• L.A. Care Health Plan: L.A. Care Health Plan is the largest publicly operated health plan in the country. The company is based in Los Angeles and serves over 1.8 million members.
• Molina HealthCare: Molina HealthCare is based in Long Beach and offers plans in six pricing regions. The company has close to 5 million members in 15 states.
• Sharp Health Plan: Since 1992, Sharp Health Plan has served San Diego and the Southern Riverside counties. The local non-profit organization offers plans in the 19 pricing regions and has several thousand affiliated doctors, including 12 local hospitals.
• Oscar Health Insurance: The relatively new carrier was founded in 2013 and joined Covered California in 2016. Oscar Health Insurance’s coverage areas include Orange County, Los Angeles County and Northeast Los Angeles County.
• Valley Health Plan (VHP): VHP has served Santa Clara County for over 30 years. The organization is a commercial HMO owned and operated locally by the county, with access to many specialists and primary care doctors, local pharmacies, and Walgreens and Safeway pharmacies nationwide.
• Western Health Advantage (WHA): WHA offers health care coverage in nine counties in Northern California. It has over 118,000 members with access to 3,200 doctors and specialists, six medical groups and 14 hospitals.

Frequently Asked Questions

Below are answers to some commonly asked questions about Medi-Cal providers.

Which Medi-Cal Plan Is Best in California?

There are various plans with varying networks in different counties within the state. The ideal option depends on your location and preferences. Feel free to get in touch with Health for California with any questions about the right option for you.

Do All Doctors Have to Accept Medi-Cal?

Not necessarily. Doctors can refuse to take Medi-Cal patients. Before receiving treatment, check whether the provider accepts Medi-Cal Fee-For-Service payments to avoid having to pay out of pocket.

Get an Insurance Quote Today

Medi-Cal is a Medicaid program that provides affordable health care plans to eligible Californians. It works with insurance companies in the state to offer coverage for low-income individuals and families. The program has expanded over the years, providing access to many physicians, hospitals, pharmacies and other facilities.

Health for California helps California residents find the best health care plans. Our online application is fast, easy and free to use. We are here to streamline the process and help you apply if you think Medi-Cal is suitable for you. Complete our form today to receive a fast and accurate health plan quote!