Medi-Cal

Benefits

A brief summary of Medi-Cal covered benefits.

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Health services

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

Mental Health Services:

  • Individual, family and group outpatient psychotherapy
  • Psychological testing to evaluate for a mental health condition
  • Psychiatric evaluation
  • Medication management
  • Outpatient services that include lab work, drugs and supplies

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

  • Applied Behavior Analysis (ABA)
  • Other evidence- based treatments

Substance Use Disorder Services:

  • Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (SABIRT)
  • Medication Assisted Treatment (MAT)
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Other services and supplies

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

  • Routine eye exams
  • Eyeglasses or contact lenses
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Transportation

  • Emergency transportation
  • Non-emergency medical transportation
  • Non-medical transportation
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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.

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

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Resources for CalOptima Health Kids and Teens

Resources for CalOptima Health Children and Teens and Your Rights

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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.

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

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Prior Authorization Requesting pre-approval for special medical services.

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

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