Benefits

A brief summary of Medi-Cal covered benefits.

Health services

Primary care doctor visits
Medical specialist visits
Hospital and emergency care
Prenatal and newborn baby care
Immunizations
Medications
Laboratory services

Behavioral health services

Outpatient psychotherapy (individual, family and group therapy)
Psychological testing to evaluate a mental health condition
Outpatient services that include lab work, drugs and supplies
Outpatient services for the purposes of monitoring drug therapy
Psychiatric consultation
Dyadic services

Behavioral Health Treatment (BHT) for members under the age of 21:

Applied Behavior Analysis (ABA)

Substance use services:

Screening, Assessment, Brief Intervention and Referral to Treatment (SABIRT)
Medication-Assisted Treatment (MAT)

Other services and supplies

Wheelchairs, walkers, crutches, etc.
Hearing aids
Home health services
Medical supplies

Vision care

Routine eye exams
Eyeglasses or contact lenses

Transportation

Emergency transportation
Non-emergency medical transportation
Non-medical transportation

Long-term services and supports

In-home supportive services
Multipurpose senior services program
Community-based adult services
Nursing facility care
Hospice care

Need to Get Health Advice?

Call the CalOptima Health Nurse Advice Phone Line at 1-844-447-8441

Note: Some services require prior authorization before it can be covered. Prior authorization is an approval for special medical services approved by your health network. Learn more about prior authorization here.

The Medi-Cal member handbook has a complete list of benefits.

Download the Medi-Cal member handbook It lists what is covered, how to get services, your rights as a member, your responsibilities, and much more.

Resources for CalOptima Health Kids and Teens

Resources for CalOptima Health Children and Teens and Your Rights

Nurse Advice Phone Line We want you to be able to get answers when you or your loved ones are sick, not feeling good or are injured.

Other programs We want to make sure you have access to the best health care possible.

Prior Authorization Requesting pre-approval for special medical services.

Services provided by different agencies Certain services are not covered by CalOptima but may be provided by a different agency.

Contact Medi-Cal Customer Service
You can contact us online or by phone, 24 hours a day, 7 days a week.
1-888-587-8088 Toll-free
711 TTY
We speak your language
Get interpreter services

New Medi-Cal Members

New member orientation schedule
Come to a meeting to learn about your new benefits
Frequently asked questions
Get quick answers to common questions about Medi-Cal

Pharmacy

About the Medi-Cal pharmacy program
Learn about your drug benefits

Forms and Documents

Common Medi-Cal forms
Authorizations, requests and more
Other important documents
Language assistance, Notice of Nondiscrimination and other helpful information.

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