An Advocate’s Guide to Medi-Cal Services

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Executive Summary

NHeLP’s Medi-Cal Services Guide 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, among others. The guide seeks to help legal aid attorneys, health advocates, and other stakeholders across California understand the Medi-Cal program and defend the health rights of low-income individuals in the State.

Relevant chapters updated in 2025 now emphasize policy changes implemented pursuant to the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including new chapters on Care Coordination and Community Supports. In addition, some chapters have been updated to reflect the changing landscape of behavioral treatment, by incorporating a description of the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) program. Chapters updated in 2025 also reflect recent changes made to Medi-Cal through the so-called “One Big Beautiful Bill Act” (OBBBA) and the 2025-2026 California budget. UPDATED DECEMBER 16, 2025

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

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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: Community Supports 
Chapter XIII: 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.

 

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