An Advocate’s Guide to Medi-Cal Services

Executive Summary

The National Health Law Program is pleased to present our updated 2022 Advocates Guide to Medi-Cal Services. NHeLP’s Medi-Cal Services Guide, first released in 2020, provides an in-depth description of some of the most important services covered in the Medi-Cal program, including prescription drug services, mental health and substance use disorder services, reproductive and sexual health services, gender-affirming services, dental services, children services, among others. 

The 2022 updated guide focuses on key changes the Medi-Cal program has undergone in recent years. In particular, relevant chapters now emphasize policy changes implemented pursuant to the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including a new chapter on Case Management and Community-Support Services, which provides insight on new services that have become widely available through implementation of CalAIM. There is also a new addendum summarizing Medi-Cal’s telehealth policy in light of changes adopted during the COVID-19 pandemic. 

The entire guide can be downloaded or individual chapters accessed below.

Chapter I: Overview of Medicaid and Medi-Cal
Chapter II: Prescription Drug
Chapter III: Mental Health Services
Chapter IV: Substance Use Disorder Services
Chapter V: Gender-Affirming Services
Chapter VI: Reproductive and Sexual Health Services
Chapter VII: Dental Services
Chapter VIII: Children’s Health Services
Chapter IX: Long-Term Services and Supports
Chapter X: Durable Medical Equipment, Orthotics and Prosthetics, and Other Non-Pharmaceutical Items
Chapter XI: Case Management and Related Community-Based Services (NEW)
Chapter XII: Ancillary Services (previously Chapter XI in the 2020 version)
Appendix A: Commonly Referenced Laws and Commonly Used Terms
Appendix B: Medi-Cal Resource List
Addendum: Telehealth in Medi-Cal (NEW)
Addendum: Accessing Medi-Cal Services During COVID-19 Pandemic (updated March 2022)

Through policy advocacy and litigation, the National Health Law Program protects and advances access to Medi-Cal coverage and services, and the rights of individuals eligible for the program. We have extensive expertise in federal and state Medi-Cal laws, regulations, and policies and share the expertise through training and assistance to California health advocates, legal services programs, private attorneys, and other stakeholders.

The National Health Law Program (NHeLP) recently conducted a four-part webinar series where we discussed some of the most important Medi-Cal policy reforms highlighted in the updated version of An Advocate’s Guide to Medi-Cal Services. The links to the recordings of each webinar are included below:

Two New Resources for Medi-Cal Consumers

Starting this year, Medi-Cal managed care plans are offering two new benefits that can help people to get all the care they need to maintain their health. This one-pager for Medi-Cal consumers provides easily accessible information about Enhanced Care Management and Community Support Services. Download the one-pager here.

Medi-Cal beneficiaries are eligible for new benefits that can help people get all the care they need to maintain their health and prevent complications. Learn more about Doula Services, Community Health Workers, and Peer Support Specialists. Download the one-pager here.

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