How do I choose a Medi-Cal managed care plan?

Available plans vary depending on your county. Managed care plans can be used as secondary insurance if families enroll in the same Medi-Cal HMO as their primary insurance (if it is available in their county). In these cases, Medi-Cal typically covers what the primary insurance doesn’t.

There are some great online resources to help you choose the right managed care plan as your child’s sole insurance coverage. You can use the California Department of Health Care Services (DHCS) to:

• Compare up to three health care or dental plans.
• Find information on standard benefits, pharmacies, urgent care centers, and more.
• Search for a specific provider or hospital to see if they accept a Medi-Cal managed care plan.
• Get contact information for each provider.

Undivided Public Benefits Specialist Lisa Concoff Kronbeck says that if you are well-established with your providers, find out if any of the providers you don’t want to lose are contracted with one of the plans. Consider the provider you'd most like to retain and find out if that provider accepts Medi-Cal, which plan, and whether you can stay with the provider if they switch to Medi-Cal only (some providers will only take a certain number of Medi-Cal patients).

If you are already with Kaiser, generally you want to go with Kaiser Medi-Cal; it can pay for some things that the private insurance plan at Kaiser wont pay for and take care of the copays. Someone may choose outside of Kaiser Medi-Cal if there is a particular provider they want, but usually it’s easiest to go with Kaiser. Concoff Kronbeck also notes that HMOs don’t play well with other insurances.

Note that a plan purchased through Covered CA that has a subsidy is duplicative of Medi-Cal, so you may not have both.

For more information, check out our article Making the Most of Medi-Cal.