How to Choose a Medi-Cal Managed Care Plan in California

If you have Medi-Cal in California, you almost certainly belong to a managed care plan, about 14.1 million of California's roughly 14.5 to 15 million Medi-Cal members are enrolled in one, which is roughly 90 percent of the program. Yet most members never learn how the system works, why their county only has certain plans, or what changed when DHCS overhauled the entire managed care market on January 1, 2024.

This guide walks through every piece of California's Medi-Cal managed care landscape: the five county delivery models, the 2024 statewide procurement, the Kaiser Permanente direct contract under SB 510 / AB 2724, the 17 publicly-organized Local Health Plans of California, the new Medi-Medi Plans that expanded to 41 counties on January 1, 2026, and the practical mechanics of choosing, or switching, your plan.

By Brevy Care Team · Last verified May 3, 2026

Why Medi-Cal Uses Managed Care

California's nearly-total reliance on managed care is a deliberate policy choice. Three goals drive it:

1. Cost predictability. DHCS pays plans a per-member-per-month (PMPM) capitated rate, which protects the General Fund from utilization spikes and shifts insurance risk to plans.
2. Care coordination at scale. A managed care plan is a single accountable entity for HEDIS quality, Enhanced Care Management (ECM), Community Supports, and the new Medi-Medi alignment.
3. CalAIM transformation lever. California's §1115 demonstration, the California Advancing and Innovating Medi-Cal (CalAIM) waiver, currently authorized through December 31, 2026 with a renewal application pending for 2027–2031, operationalizes initiatives like ECM, Community Supports, justice-involved coverage, and behavioral health integration through the contracts DHCS holds with managed care plans. Fee-for-service Medi-Cal lacks the contractual touchpoints to do this.

The federal authorities underlying the system are layered: §1915(b) freedom-of-choice waiver (renewed every two years), §1115 CalAIM demonstration, §1932(a) state plan authority for COHS counties, and assorted State Plan Amendments for things like Medi-Cal Rx and EPSDT.

DHCS describes its strategic direction in the 2024 contract as transforming Medi-Cal "into a more consistent, seamless, statewide system that improves equity, quality, and outcomes."

The Five County Delivery Models

Effective January 1, 2024, DHCS reorganized the managed care market into five operating models. Older articles still reference the historical four-model taxonomy (COHS / Two-Plan / GMC / Regional); the 2024 procurement created a fifth bucket called Single-Plan, where a Local Initiative serves as the sole plan in counties that previously had a Two-Plan structure.

A separate Kaiser Permanente direct contract overlays 32 counties as a parallel pathway for eligible members, but Kaiser is not a county model; it is a separate eligibility track described later in this guide.

County Organized Health Systems, All Six Plans

COHS plans are public agencies established under W&I Code §14087.54 et seq. by county boards of supervisors. They are not for profit, governed by county-appointed boards, and have no commercial competitor in their counties.

1. Partnership HealthPlan of California. 24 NorCal counties, Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Nevada, Placer, Plumas, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Yolo, Yuba. About 950,000 members. Member Services: (800) 863-4155. Headquartered in Fairfield. Partnership absorbed 10 former Regional Model counties when the 2024 procurement took effect.

2. CalOptima Health. Orange County only. About 935,000 Medi-Cal members plus the largest Medi-Cal PACE program in California (520+ participants). Member Services: (888) 587-8088. OneCare D-SNP / Medi-Medi Plan: (877) 412-2734.

3. CenCal Health. Santa Barbara and San Luis Obispo. About 225,000 members. Member Services: (877) 814-1861 (Santa Barbara) / (877) 814-1862 (San Luis Obispo). Founded 1983; the first non-Orange-County COHS in California.

4. Central California Alliance for Health (the Alliance). Mariposa, Merced, Monterey, San Benito, Santa Cruz. About 415,000 members. Member Services: (800) 700-3874. Launched its Medi-Medi Plan across all five counties on 1/1/2026, the largest single-plan EAE D-SNP geographic expansion of the year.

5. Gold Coast Health Plan. Ventura County. About 215,000 members. Member Services: (888) 301-1228. The newest COHS (founded 2010), deeply integrated with Ventura County Medical Center.

6. Health Plan of San Mateo (HPSM). San Mateo County. About 150,000 Medi-Cal members plus 9,000 CareAdvantage dual-eligibles. Member Services: (800) 750-4776. HPSM is the only managed care entity in California that integrates Medi-Cal and In-Home Supportive Services (IHSS) coordination under one roof, and is consistently one of the top-rated Medi-Cal plans on the Office of the Patient Advocate Report Card.

Single-Plan Counties

Effective 1/1/2024, six counties operate as Single-Plan counties: Alameda (Alameda Alliance for Health), Contra Costa (Contra Costa Health Plan), Imperial (Community Health Plan of Imperial Valley), and a handful of others where the Local Initiative is the only plan.

The most consequential transition was in Imperial County, where the prior commercial contract held by California Health & Wellness (a Centene subsidiary) was non-renewed. About 105,000 Medi-Cal enrollees moved to Community Health Plan of Imperial Valley (CHPIV), a new not-for-profit entity launched in partnership with the Imperial County Health Department.

Two-Plan Counties, County by County

The Two-Plan model preserves member choice between a Local Initiative and a single commercial plan. The active Two-Plan pairs as of 2026:

A note on Los Angeles. DHCS still labels LA a Two-Plan county, but in practice LA members can pick from L.A. Care, Anthem, Blue Shield Promise, Health Net (with embedded 50% Molina subcontract), or Kaiser direct. L.A. Care is the largest publicly-operated health plan in the United States, with 2.5 million-plus Medi-Cal members.

Geographic Managed Care (GMC), Sacramento and San Diego

GMC counties are the only ones where multiple commercial plans compete with no Local Initiative.

• Sacramento (effective 1/1/2024): Anthem Blue Cross, Health Net, Kaiser direct, Molina. (Aetna exited.)
• San Diego (effective 1/1/2024): Blue Shield Promise, Community Health Group, Kaiser direct, Molina. (Aetna exited; Health Net lost San Diego in the 2024 procurement.)

Combined GMC enrollment is roughly 1.2 million members.

The Regional Model, Smaller Now Than Before

The Regional Model was historically used for the lowest-population counties. It shrank dramatically in 2024 because Partnership HealthPlan absorbed Butte, Colusa, Glenn, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, and Yuba. The remaining Regional counties are Amador, Calaveras, Inyo, Mono, and Tuolumne, all "Anthem + Health Net" pairs.

The 2024 Statewide Procurement

The 2024 procurement was the largest reshaping of California Medi-Cal managed care in the program's history. It restructured commercial contracts, set new quality and equity requirements, and created a meaningfully different competitive landscape.

Timeline

The contracts run 5 years (1/1/2024 – 12/31/2028), with up to two 2-year DHCS-option extensions. The next competitive procurement (2029 contract effective date) is expected to launch in Q1 2027.

The Five Commercial Winners

1. Anthem Blue Cross Partnership Plan (Elevance Health), 14 counties: Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings, Madera, Mono, Sacramento, San Francisco, Santa Clara, Tuolumne. Roughly 1.6 million members statewide. Member Services: (800) 407-4627.
2. Health Net Community Solutions (Centene), 10 counties: Amador, Calaveras, Inyo, Los Angeles (with 50% Molina subcontract), Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne. Roughly 1.3 million members. Member Services: (800) 675-6110.
3. Molina Healthcare of California, Riverside, San Bernardino, Sacramento, San Diego, plus 50% of Los Angeles via the Health Net subcontract. Roughly 1.2 million members. Member Services: (888) 665-4621.
4. Blue Shield of California Promise Health Plan, San Diego County. Roughly 280,000 members. Member Services: (800) 605-2556.
5. Community Health Group Partnership Plan, San Diego County. Roughly 365,000 members. Member Services: (800) 224-7766.

Who Lost Coverage

• Aetna Better Health of California exited the Medi-Cal market entirely 1/1/2024 after losing both Sacramento and San Diego.
• Health Net lost San Diego, where Blue Shield Promise, Community Health Group, Molina, and Kaiser now serve members.
• Health Net initially lost Los Angeles entirely in the August 2022 award; the December 2022 Joint Statement settlement restored it via the 50/50 Molina subcontract.
• California Health & Wellness (Centene) lost Imperial County, which transitioned to CHPIV.

What DHCS Wanted From the Procurement

DHCS articulated four explicit goals in the boilerplate contract:

1. Standardize quality, single uniform 3% Quality Withhold tied to HEDIS performance, NCQA accreditation required by 2026.
2. Improve health equity, mandatory health equity officer, race/ethnicity/language/disability data collection, equity-focused stratified reporting.
3. Reduce administrative burden, standardized credentialing, single utilization-management framework, common provider directory file format.
4. Strengthen oversight, enhanced sanctions, public ratings, mandatory corrective action plans (CAPs) for failure to meet benchmarks.

The Kaiser Permanente Direct Contract, SB 510 and AB 2724

Kaiser Permanente operates under a special arrangement that no other commercial Medi-Cal plan has: a direct statewide contract with DHCS, authorized by Senate Bill 510 (2021, Pan) and codified in Assembly Bill 2724 (2022, Arambula). The contract took effect January 1, 2024.

Service Area, 32 Counties

Alameda, Amador, Contra Costa, El Dorado, Fresno, Imperial, Kern, Kings, Los Angeles, Madera, Marin, Mariposa, Napa, Orange, Placer, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Stanislaus, Sutter, Tulare, Ventura, Yolo, Yuba.

This expanded Kaiser's Medi-Cal footprint from 22 counties (where it had served Medi-Cal via subcontracts to Local Initiatives) to 32, adding 10 new counties where Kaiser had a commercial line but had not previously offered Medi-Cal.

Who Can Enroll With Kaiser

Kaiser's Medi-Cal eligibility is restricted, not every Medi-Cal member can pick Kaiser. Eligible enrollees are:

1. Existing Kaiser members, anyone who held Kaiser commercial or Medi-Cal coverage between 1/1/2023 and 12/31/2023 (the contract's "lookback window").
2. Family-linked members, household members of an existing Kaiser enrollee.
3. Foster youth and former foster youth, any FFY in Kaiser's footprint, regardless of prior enrollment.
4. Dual-eligibles, open enrollment for full-benefit Medicare + Medi-Cal members.
5. Continuity-of-care transferees, members who transitioned to Kaiser through prior county subcontracts can re-enroll.
6. Whole Child Model and CCS-eligible children in Kaiser's footprint.

Kaiser is also the default plan for newborns of enrolled members and for newly Medi-Cal-eligible household members of Kaiser enrollees.

Membership and Quality

Pre-contract Kaiser had about 900,000 Medi-Cal members assigned via subcontracts. By early 2026, that figure is approximately 1.1 million. Kaiser committed to 25% growth in new Medi-Cal members from a 7/1/2024 baseline through the contract end.

Kaiser's NCQA Medicaid plan rating is consistently among the highest in California. Its closed-system, vertically integrated model (Kaiser-employed clinicians, Kaiser-owned hospitals) drives both that quality consistency and the eligibility restriction: Kaiser does not subcontract to outside networks.

The 17 Local Health Plans of California

The Local Health Plans of California (LHPC) is the trade association for the state's 17 publicly-organized Medi-Cal plans, the COHS plans plus the Local Initiatives in Two-Plan and Single-Plan counties. Together they cover roughly 9.9 million Medi-Cal members, or about 70% of all managed care members.

Plan Ratings and Quality

DHCS publishes annual quality ratings through three channels: the Office of the Patient Advocate (OPA) Health Plan Quality Report Card at reportcard.opa.ca.gov, the Medi-Cal Managed Care Performance Dashboard, and stand-alone Quality Improvement Reports.

Ratings are based on the Managed Care Accountability Set (MCAS), a fixed list of HEDIS, CAHPS, and DHCS-specific measures. Two key thresholds apply:

• Minimum Performance Level (MPL): national Medicaid 50th percentile.
• High Performance Level (HPL): national Medicaid 90th percentile.

Plans that fall below MPL face monetary sanctions, mandatory Corrective Action Plans, and public posting on the DHCS dashboard. Under the 2024 contract, plans below MPL on a defined subset of MCAS measures forfeit up to 3% of their capitation revenue, the new Quality Withhold.

NCQA Medicaid plan ratings (released each September on a 0–5 star scale) are the other consumer-facing tool. Ratings vary year over year; check the current NCQA Medicaid Health Plan Ratings page or the Office of the Patient Advocate Report Card for your county's plan before making a decision. Kaiser Permanente's California Medicaid plans have historically rated near the top of the state.

The 2026 NCQA ratings will be released September 15, 2026.

Plan-by-Plan Snapshot

What follows is a quick reference for the larger plans serving California Medi-Cal members.

L.A. Care Health Plan. Los Angeles only. 2.5M+ members. Polaris integrated care management portal. Community Resource Centers in Boyle Heights, Inglewood, Lynwood, Pacoima, El Monte, Palmdale, Norwalk, and West Covina. L.A. Care Medicare Plus D-SNP launched 2025.

Inland Empire Health Plan (IEHP). Riverside, San Bernardino. 1.5M members. IEHP DualChoice D-SNP / Medi-Medi Plan effective 1/1/2026. Loma Linda University Health and Riverside University Health System partnerships.

CalOptima Health. Orange County. ~935K members. Largest Medi-Cal PACE program in California. OneCare D-SNP / Medi-Medi Plan. Whole Child Model integration with CHOC.

Partnership HealthPlan. 24 NorCal counties. 950K members. UC Davis Health affiliation; Wellness & Recovery substance use program; Medi-Medi Plan launch expected 2027.

Anthem Blue Cross Partnership Plan. 14 counties. ~1.6M members. National Medicaid platform; Anthem MediBlue Coordination Plus D-SNP / Medi-Medi Plan in LA, Sacramento, and Santa Clara.

Health Net Community Solutions (Centene). 10 counties. ~1.3M members. Wellcare Dual Liberty D-SNP in LA; manages CalViva Health under sub-cap.

Molina Healthcare of California. Riverside, San Bernardino, Sacramento, San Diego, plus 50% LA via Health Net sub. ~1.2M members. Molina Dual Options D-SNP / Medi-Medi Plan. Founded in California 1980.

Kaiser Permanente Medi-Cal. 32 counties. ~1.1M members. Historically among the top-rated California Medicaid plans on NCQA. Vertically integrated; restricted enrollment.

Health Plan of San Mateo (HPSM). San Mateo. 150K members + 9K CareAdvantage duals. Consistently top-rated CA Medicaid plan on the Office of the Patient Advocate Report Card. Single integrated COHS for Medi-Cal + IHSS coordination.

Central California Alliance for Health. Mariposa, Merced, Monterey, San Benito, Santa Cruz. 415K members. Largest 2026 EAE D-SNP geographic expansion.

Blue Shield of California Promise Health Plan. San Diego (Medi-Cal); LA (legacy D-SNP). ~280K members. UCSD Health and Sharp HealthCare network; Blue Shield TotalDual Plan.

Santa Clara Family Health Plan. Santa Clara. 290K members. SCFHP DualConnect Medi-Medi Plan effective 1/1/2025.

Alameda Alliance for Health. Alameda. 415K members. Alliance Wellness D-SNP launched 1/1/2026 (the plan's first Medicare product).

Contra Costa Health Plan. Contra Costa. 285K members. First federally qualified, state-licensed, county-sponsored HMO in the United States (founded 1973).

San Francisco Health Plan. San Francisco. 165K members. Tightly integrated with the SF Department of Public Health and Zuckerberg San Francisco General; legacy Cal MediConnect wound down to Medi-Medi Plan effective 1/1/2026.

Health Plan of San Joaquin / Mountain Valley Health Plan. San Joaquin, Stanislaus, Alpine, El Dorado. ~450K members. $100M Community Reinvestment Program launched 3/2024.

Kern Family Health Care. Kern County. 330K members. Kern Medical Center deep integration.

Medi-Medi Plans, The Big 2026 Change

If you are dually eligible for Medicare and Medi-Cal, the most important thing that happened on January 1, 2026 was the expansion of Medi-Medi Plans, California's brand for Exclusively Aligned Enrollment Dual-Eligible Special Needs Plans (EAE D-SNPs), from 12 counties to 41 counties.

A Medi-Medi Plan combines Medicare Advantage coverage with the matching Medi-Cal MCP into a single integrated plan: one ID card, one provider directory, one care coordination team, and one set of customer service numbers.

Before 2025, dual-eligibles in California typically had to navigate two separate plans for two separate programs, a situation the federal government calls "misaligned enrollment."

The 2026 expansion counties (29 new): Alameda, Alpine, Amador, Calaveras, Contra Costa, El Dorado, Imperial, Inyo, Kern, Mariposa, Marin, Merced, Mono, Monterey, Napa, Placer, San Benito, San Francisco, San Joaquin, San Luis Obispo, Santa Barbara, Santa Cruz, Solano, Sonoma, Stanislaus, Tuolumne, Ventura, Yolo, Yuba.

Existing 2025 Medi-Medi counties (12): Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, Tulare.

The Matching Plan Policy

The mechanism that drives alignment is DHCS' Matching Plan Policy, finalized in All Plan Letter (APL) 24-013 in December 2024 and operationalized 1/1/2025. The rule: when a full-benefit dual-eligible newly enrolls in a Medicare Advantage plan in an EAE-eligible county, their Medi-Cal plan must align with the MA plan if a matching Medi-Cal plan exists from the same parent company.

Auto-alignment now flows in both directions:

• D-SNP-to-Medi-Cal: A new D-SNP enrollee is auto-aligned to the matching parent company's Medi-Cal plan.
• Medi-Cal-to-D-SNP: A Medi-Cal member newly eligible for Medicare may be passively enrolled into the matching parent's D-SNP under the Default Enrollment Pilot, currently active in San Diego and San Mateo.

Los Angeles 2026 Medi-Medi Plans

Seven Medi-Medi Plans are available in Los Angeles for plan year 2026:

1. Anthem MediBlue Coordination Plus (HMO D-SNP)
2. Blue Shield TotalDual Plan (HMO D-SNP)
3. Kaiser Permanente Senior Advantage Medicare-Medicaid Plan
4. L.A. Care Medicare Plus (HMO D-SNP)
5. Molina Dual Options
6. SCAN Connections at Home (HMO D-SNP)
7. Wellcare Dual Liberty (Health Net subsidiary HMO D-SNP)

Closure of Non-Aligned D-SNPs

Per DHCS direction implementing Section 1859 of the Social Security Act and CMS' 2024 D-SNP rule, non-aligned D-SNPs (Medicare plans without a matching Medi-Cal MCO in the EAE county) are closed to new dual-eligible enrollment in EAE counties. Existing members can stay enrolled but will face attrition over time. DHCS expects most non-aligned D-SNPs to wind down by 2028.

Counties Without 2026 Medi-Medi Plans

The 17 counties without 2026 Medi-Medi coverage are largely Partnership HealthPlan (NorCal) and remaining Regional Model rural counties. Partnership has stated its intent to launch its own Medi-Medi Plan in 2027.

How to Choose a Plan

When DHCS approves your Medi-Cal application, Health Care Options (HCO) will mail you a Choice Form. You have 30 calendar days to pick a plan. If you do not, DHCS' algorithm will auto-assign one based on:

1. Provider continuity, assigning to a plan that includes your most recent claims-derived primary care provider, if known.
2. Family unit alignment, assigning to the plan covering other Medi-Cal members in your household.
3. Random assignment within the county's capacity proportions.

The Five Things That Matter Most

1. Provider network. Does the plan include your existing primary care provider, specialists, and hospital? Use the plan's online directory or call the plan.
2. Specialist access. Particularly important for cancer, kidney disease, complex pediatric care, transplants. Evaluate the plan's specialist roster and referral process.
3. Pharmacy. Plan choice does NOT affect pharmacy network, Medi-Cal pharmacy is statewide fee-for-service through Medi-Cal Rx (Magellan). Every Medi-Cal pharmacy in California accepts every Medi-Cal member.
4. Behavioral health. Mild-to-moderate mental health and substance use is administered by your plan; severe/specialty mental health is carved out to the County Mental Health Plan. Check the plan's behavioral health provider network and follow-up performance.
5. Plan ratings. Check the OPA Report Card at reportcard.opa.ca.gov and the NCQA rating for each plan in your county.

Where to Find Information

• Health Care Options (statewide enrollment broker): (800) 430-4263 (TTY 1-800-430-7077). Monday–Friday, 8 AM – 6 PM Pacific.
• HCO online portal: healthcareoptions.dhcs.ca.gov, search by county, view plans, enroll online.
• Plan websites: Each plan publishes an online provider directory updated monthly per DHCS APL 23-014.
• Office of the Patient Advocate Report Card: reportcard.opa.ca.gov, quality and consumer satisfaction ratings on a 1-to-5-star scale.

Switching Plans

You are not stuck with the first plan you choose.

The Initial 90-Day Open Switch

For your first 90 calendar days after enrollment, you can switch plans for any reason, no cause needed. To switch:

• Online: Healthcareoptions.dhcs.ca.gov "Change My Plan."
• Phone: Health Care Options (800) 430-4263.
• Paper: Mail in a Choice Form.

The new plan typically takes effect on the first of the month following the switch request, and continuity-of-care protections kick in immediately.

After 90 Days, Once Per Year, Plus Good Cause

Past the 90-day open window, you can switch once per 12-month rolling period without showing cause. You can also switch any time, unlimited, for any of the following good causes:

• You move out of the plan's service area.
• You need related services (e.g., transplant) provided by a network not in your current plan.
• Your PCP, specialist, or hospital leaves the plan's network.
• Lack of access to providers experienced in addressing your health care needs.
• Documented quality-of-care concerns, established through a grievance.
• For dual-eligibles, a Medicare plan change that requires Medi-Cal alignment under the Matching Plan Policy.

Continuity of Care, Up to 12 Months

When you switch plans, the new plan must honor your existing provider relationships for up to 12 months for:

• Out-of-network providers with established relationships (defined as having seen the provider in the 12 months prior to switching).
• Active treatment authorizations (for the first 90 days minimum).
• Prescriptions, durable medical equipment (DME), and ongoing therapies.

To request continuity of care, you or your provider must submit a formal request to the new plan within 30 days of plan transition; the plan has 30 calendar days to respond.

The 12-month CoC clock can reset once if you change plans during your first 12 months. After two changes, the right to a new 12-month period extinguishes.

What Your Plan Actually Covers, and What It Does Not

A surprising amount of Medi-Cal sits outside the managed care plan's scope. The most important carve-outs for members to understand:

Pharmacy, Medi-Cal Rx (Statewide)

Effective January 1, 2022, all outpatient prescription drugs and pharmacy-billed medical supplies were carved out of Medi-Cal MCO contracts and transitioned to a statewide fee-for-service program administered by Magellan Medicaid Administration, a subsidiary of Magellan Health (now owned by Centene).

The Medi-Cal Rx carve-out includes outpatient pharmacy claims, physician-administered drugs dispensed by a pharmacy, medical supplies dispensed by a pharmacy, and enteral nutritional products dispensed by a pharmacy. Physician-administered drugs billed on a medical claim (chemotherapy infusions, in-office monoclonal antibodies, long-acting injectables administered in clinic) stay in MCO scope.

For members, the practical implication: plan choice does not affect your pharmacy network. Every Medi-Cal pharmacy in California accepts the same Medi-Cal Rx BIN/PCN, regardless of MCO.

Phone: Medi-Cal Rx Customer Service (800) 977-2273.

Behavioral Health, Three-Layer Carve-Out

California's behavioral health architecture splits responsibility three ways:

1. Specialty Mental Health Services (SMHS), for adults with serious mental illness (SMI) and youth with serious emotional disturbance (SED). Delivered by 58 County Mental Health Plans, one per county, under §1915(b) waiver authority. Your MCP is not the responsible payer.
2. Drug Medi-Cal Organized Delivery System (DMC-ODS), for substance use disorder treatment in opt-in counties. As of 2026, 40 counties operate DMC-ODS, representing about 95% of the state population. In non-DMC-ODS counties, SUD is delivered through traditional Drug Medi-Cal.
3. Mild-to-moderate mental health and SUD (in non-DMC-ODS counties), administered by your MCP. Includes outpatient therapy, medication management, and screenings.

You can self-refer to the County MHP or be referred by your MCP via the No Wrong Door policy effective 7/1/2022.

Dental, County-Specific

• Most counties (56 of 58): Medi-Cal Dental is fee-for-service, with Delta Dental of California as fiscal intermediary processing claims. You can see any participating Medi-Cal Dental provider.
• Sacramento County: Mandatory Dental Managed Care (DMC). Members must enroll in Access Dental, Health Net Dental, or LIBERTY Dental.
• Los Angeles County: Voluntary DMC. Members may choose DMC or stay in Medi-Cal Dental fee-for-service.

Phone: Medi-Cal Dental (800) 322-6384.

Vision and Transportation, In-Plan

Vision benefits (eye exams, glasses) are in your plan, typically through Vision Service Plan (VSP) or March Vision subcontracts. Non-Emergency Medical Transportation (NEMT) and Non-Medical Transportation (NMT) are also in your plan, usually through brokers like ModivCare, MTM, or Roundtrip.

Enhanced Care Management (ECM), In-Plan

ECM provides intensive care coordination for members with complex needs. Each MCP offers ECM to members in defined Populations of Focus (POFs):

• Adults experiencing homelessness.
• Adults at risk of avoidable hospital or ED use.
• Adults with serious mental illness or substance use disorder.
• Adults transitioning from incarceration (justice-involved POF, started 1/1/2024).
• Adults in long-term care nursing facilities transitioning to community.
• Children and youth involved in child welfare.
• Youth with complex behavioral health.
• Pregnant or postpartum individuals with high-risk conditions.
• The Birth Equity POF (effective 1/1/2025).

Community Supports, In-Plan, Optional

Community Supports (formerly "in-lieu-of services" or ILOS) are 14 voluntary services MCPs may offer in lieu of traditional Medi-Cal services. Examples:

• Housing transition navigation services.
• Housing tenancy and sustaining services.
• Recuperative care / medical respite.
• Sobering centers.
• Asthma remediation.
• Medically tailored meals.
• Personal care / homemaker services.
• Day habilitation programs.

As of 2026 all 14 services are offered by at least one MCP statewide; menu coverage varies by plan and county.

Other 2026 Changes Members Should Know About

Asset limit reinstatement (1/1/2026). Per AB 116 (Ch. 21, Stats. 2025), the non-MAGI Medi-Cal asset limit was reinstated at $130,000 individual / $195,000 couple (with $65,000 added for each additional household member). The reinstatement affects Aged & Disabled, Medically Needy, 250% Working Disabled, long-term care, and Medicare Savings Program members. Pickle Amendment, Disabled Adult Children, and Disabled Widows/Widowers categories are exempt. (See our Medi-Cal eligibility and income limits guide for full detail.)

UIS adult enrollment freeze (1/1/2026). AB 116 also imposed a freeze on new full-scope Medi-Cal enrollment for adults without satisfactory immigration status (UIS). Existing UIS adult enrollees remain enrolled as long as they remain otherwise eligible; the freeze applies only to new applicants 19+. UIS children, pregnant individuals, and emergency Medi-Cal services continue.

Behavioral Health Bridge Housing (BHBH). The BHBH program, short-term and long-term housing for people experiencing homelessness who have serious behavioral health conditions, has funding through 6/30/2027 per the 2025-26 Budget Act. MCPs partner with counties on BHBH placements as part of ECM and Community Supports.

Proposition 1 / BHSA implementation (7/1/2026). Proposition 1 (passed March 2024) transformed the Mental Health Services Act into the Behavioral Health Services Act (BHSA). New BHSA spending categories take effect 7/1/2026 for most counties, with dedicated allocations for housing interventions and Full-Service Partnership services for people with serious mental illness or serious emotional disturbance, populations that overlap heavily with MCP enrollees in ECM.

Individual Placement and Support (IPS) Supported Employment (7/1/2026). IPS becomes a Medi-Cal-reimbursable service. MCPs are required to refer eligible members with SMI to IPS providers.

CalAIM 2027–2031 renewal. DHCS is negotiating CMS approval for CalAIM 2.0. Expected components: expanded Population Health Management, more ECM Populations of Focus, justice-involved coverage 90 days pre-release, expanded Community Supports menu. CMS approval is anticipated in late December 2026 with implementation beginning 1/1/2027.

Bottom Line

If you are on Medi-Cal in California, your managed care plan is the front door to almost every benefit you have. The right plan is the one whose network includes your doctor, whose specialists you can actually access, and whose performance ratings on the metrics you care about (postpartum care, behavioral health, chronic disease management) are strong.

Five things to remember:

1. You probably have more choice than you realize, Two-Plan, GMC, and Regional counties all let you pick. COHS and Single-Plan counties do not, but you still pick your providers within the plan.
2. Health Care Options at 1-800-430-4263 is the single statewide tool for choosing, switching, and getting straight answers about your county's plan options.
3. You can switch plans for any reason within 90 days of initial enrollment, and once a year after that, plus unlimited switches for "good cause."
4. Continuity of care up to 12 months protects your existing provider relationships when you switch plans.
5. Pharmacy, severe mental health, and most dental are carved out, your plan choice does not affect those services.

Statewide Reference Numbers

For complete coverage of related topics, see our Medi-Cal eligibility and income limits guide, our step-by-step Medi-Cal application guide, and our overview of all Medi-Cal programs.

This guide reflects Medi-Cal managed care policy current through the 2024 procurement, the SB 510 / AB 2724 Kaiser direct contract, the 1/1/2026 Medi-Medi Plan expansion, and the FY 2025-26 budget package (AB 116). Plan ratings, county configurations, and Medi-Medi Plan participation can change, verify current detail with DHCS or Health Care Options before making any irreversible decision.

Find personalized help choosing a Medi-Cal managed care plan at brevy.com.