Individuals and families in Medi-Cal HMO plans in 22 counties across the state may have to select a new health plan and doctors beginning January 2024. The Department of Health Care Services is transforming the Medi-Cal health plans with new requirements with the aim to improve health care quality. Implementation of the new contracts, along with certain changes at the county level, will result in 1.2 million individuals having new Medi-Cal plan options.
Counties Lose Medi-Cal Plans, Add New Plans
Some counties will lose their existing 2023 Medi-Cal plans. Individuals enrolled in those plans being terminated need to enroll in a new plan for 2024. Some counties will be adding Medi-Cal health plans. The following information is from Department of Health Care Services documents and websites and is accurate as of November 2023.
This is the list of counties that will be directly affected and will be replacing health plans for 2024. The plans listed are the options that Medi-Cal beneficiaries will have for 2024.
- Alameda: Alameda Alliance, Kaiser
- Alpine: Anthem Blue Cross, Health Plan of San Joaquin
- Amador: Anthem Blue Cross, Health Net, Kaiser
- Butte: Partnership Health Plan of California
- Colusa: Partnership Health Plan of California
- Contra Costa: Contra Costa Health Plan, Kaiser
- El Dorado: Anthem Blue Cross, Health Plan of San Joaquin, Kaiser
- Glenn: Partnership Health Plan of California
- Imperial: Community Health Plan of Imperial Valley, Kaiser
- Kern: Anthem Blue Cross, Kern Family Health Care, Kaiser
- Los Angeles: Health Net/Molina, L.A. Care, Kaiser
- Mariposa: Central California Alliance for Health, Kaiser
- Nevada: Partnership Health Plan of California
- Placer: Partnership Health Plan of California, Kaiser
- Plumas: Partnership Health Plan of California
- Sacramento: Anthem Blue Cross, Health Net, Molina, Kaiser
- San Benito: Central California Alliance for Health
- San Diego: Blue Shield, Community Health Group, Kaiser, Molina
- Sierra: Partnership Health Plan of California
- Sutter: Partnership Health Plan of California, Kaiser
- Tehama: Partnership Health Plan of California
- Yuba: Partnership Health Plan of California, Kaiser
The California Department of Health Care Services is marketing all the Medi-Cal plan changes as a transition. If you are in a health plan that is being terminated, you can transition to a new plan being offered. In some instances, if you do not make an active selection, you or your family members will be transitioned into a new plan.
Medi-Cal Benefits, Eligibility Will Not Change
This Medi-Cal transition will not change any health or dental benefits offered to beneficiaries. The eligibility conditions to qualify for Medi-Cal will not change. You may be required to select a new health plan if your current 2023 health plan is being eliminated. In addition, you may have to select a new Primary Care Physician within the new Medi-Cal HMO managed care plan.
Continuity of Care
What happens if you are receiving health care for an ongoing illness and your primary doctors, specialists, and facilities are not in network with the new Medi-Cal plan? Medi-Cal has loosened the Continuity of Care provisions so people can keep providers who are providing them with treatment for their illness. While some of the conditions for Continuity of Care have been liberalized, there will still be paperwork involved to keep those providers.
Many individuals and families will notice that Kaiser Permanente has been added to the Medi-Cal HMO managed care plan options in many counties. However, enrollment in the Kaiser Medi-Cal plan is conditional. First, you must live within a certain distance of the Kaiser facilities in your county. Second, Kaiser is open to people already enrolled in Kaiser Medi-Cal, who have been Kaiser members in the past year, or have an immediate family member in Kaiser. There will be exceptions for individuals who are dual-eligible (Medicare & Medi-Cal) and foster care youth.
To learn about the Medi-Cal transition you can visit Medi-Cal Managed Care Health Care Options.
To find out the new Medi-Cal plans offered in your county you can visit Medi-Cal Managed Care Plan Transition. On this page you can enter your county and view which plan are being terminated and the new options. Below are some of the documents released by DHCS to support the transition.