Medi-Cal Explained

Medi-Cal is the foundation of California’s health care safety net and a major component of the state’s budget. The Medi-Cal Explained series provides an overview of the program, including the people it serves, the services it provides, and how it is organized, managed, and financed.

Medi-Cal Explained: Medi-Cal Financing and Spending

Payment & Financing, Medi-Cal

This issue brief illustrates how Medi-Cal is financed and the factors that impact total spending on health services through the program.

Medi-Cal Explained: 2024 Medi-Cal Managed Care Plans by County

In 2024, many California counties will experience major changes around which Medi-Cal managed care plans operate there. This fact sheet organizes these changes alphabetically by county and by managed care plan for easy reference.

Medi-Cal Waivers and State Plan Amendments

Two fact sheets and one short slide deck provide an overview of Medicaid waivers and State Plan Amendments, and how they are used in California.

Medi-Cal Member Advisory Committee

This report presents recommendations that informed the design of the Medi-Cal Member Advisory Committee. It also summarizes the research and feedback that informed those recommendations.

The Medi-Cal Program: An Overview

This publication offers an overview of the Medi-Cal program, which provides health coverage in California for children and their parents with low incomes, pregnant women, seniors, and nonelderly adults, including people with disabilities.

Medi-Cal Explained: New Medi-Cal Services at a Glance (2020–2023)

Medi-Cal Explained

This fact sheet outlines new non-specialty mental health services as well as services introduced as part of the CalAIM initiative. It also covers benefits that establish a new billable provider type, such as community health workers.

Designing Medi-Cal Consumer Advisory Committees

This report presents findings from a survey of Medi-Cal managed care plans that sought to understand their practices and experiences running consumer advisory committees.

Medi-Cal Explained: What Are Alternative Payment Models?

This issue brief explores how Medi-Cal has been developing alternative payment models to align with federal initiatives and state financial and policy goals. It looks at the benefits of these models and barriers to their adoption.

Medi-Cal Explained: How Health Centers Are Paid

Learn about payment methods for community health centers and Federally Qualified Health Centers, including prospective payment system reimbursement.

Medi-Cal Explained: Administration of Non-Specialty Mental Health Services

This fact sheet lists all 2024 Medi-Cal managed care plans and indicates how they cover non-specialty mental health services.

Long-Term Services and Supports in Medi-Cal

Millions of Californians covered by Medi-Cal live with disabling conditions or chronic illnesses and require assistance with common activities of daily living, such as bathing, dressing, and eating. In California, a patchwork of programs provide services to help these people; they are known as long-term services and supports (LTSS).

Maternity Care and Paying for Maternity Services

Medi-Cal, Maternal Health

Learn about maternity coverage in Medi-Cal, including eligibility, covered services, and payment.

October 24, 2019

Webinar — Medi-Cal Explained: Waivers and State Plan Amendments

October 24, 2019

As California is set to launch the California Advancing and Innovating Medi-Cal (CalAIM) initiative, brush up on the fundamentals of waivers and State Plan Amendments, including what's in California's current Section 1115 and Section 1915(b) waivers.

Medi-Cal Explained: Managed Care Plan Procurement

Medi-Cal, Payment & Financing

This brief explains what the 2021 Medi-Cal managed care reprocurement process is and what it means for millions of Californians served by Medi-Cal.

Medi-Cal Eligibility and Enrollment: Current Status and Challenges

This fact sheet provides an overview of the eligibility determination and enrollment process for the Medi-Cal program.

Medi-Cal Payment to Managed Care Plans: Current Process and Challenges

This fact sheet provides an overview of Medi-Cal managed care plans and how they are structured.

Medi-Cal and Behavioral Health Services

Medi-Cal, Behavioral Health

This fact sheet provides a high-level overview of how mental and behavioral health issues are managed in the Medi-Cal program.

The Medi-Cal Budget

This fact sheet describes the organization, funding sources, and process for developing the Medi-Cal program budget.

February 25, 2019

Briefing — Medi-Cal Explained: An Overview of Program Basics

February 25, 2019

This briefing provided an overview of the basics of the Medi-Cal program, including eligibility and enrollment, organization, oversight, and financing.

Accountability in the Medi-Cal Managed Care Program

This fact sheet provides an overview of how the Department of Health Care Services assesses quality of care provided by the more than 30 full-service and specialty managed care plans that participate in Medi-Cal's managed care program.