Medi-Cal Benefits & Services
With L.A. Care, you can enjoy peace of mind knowing that your health care needs are taken care of. If you have questions about what is covered or not covered, please call L.A. Care at 1-888-839-9909 (TTY 711). This page highlights benefits and services offered to you as an L.A. Care Medi-Cal member. Some of the services that are covered:
- Primary Care Doctor, Wellness, and Specialist visits
- Hospital and Emergency Services
- Urgent Care and Retail Clinics
- Disease Management Programs
- Family Planning Services
- Lab Services and X-rays
- Immunizations
- Pediatric Services
- Dialysis/Hemodialysis
For complete and detailed benefit information, please review the L.A. Care Medi-Cal Evidence of Coverage (EOC), also known as the L.A. Care Medi-Cal member handbook.
Medi-Cal for Kids & Teens
L.A. Care provides Medi-Cal services for children and young adults under the age of 21. This includes regular check-ups and other preventive and treatment services needed to stay or get healthy. Learn more about Medi-Cal for Kids & Teens.
Some of the services that are covered:
- Primary care and specialist visits
- Behavioral health treatment services
- Dental services
- Vision services, including eyeglasses
- Hearing services
- Transportation to and from medical appointments
All children enrolled in Medi-Cal have the right to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. In California, EPSDT is called Medi-Cal for Kids & Teens. Learn more about Medi-Cal for Kids & Teens rights.
Other Services
L.A. Care is partnered with Teladoc® to offer you access to board-certified doctors by phone or video 24 hours a day, 7 days a week, anywhere you are in California. Learn more about telehealth with Teladoc.
You can also request a phone or video visit with many of L.A. Care’s in-network providers.
The Nurse Advice Line offers L.A. Care Medi-Cal members assistance with any health related questions 24 hours a day, 7 days a week.
Call 1-800-249-3619 (TTY 711) or visit our Nurse Advice Line web page.
L.A. Care Medi-Cal members can get transportation to and from health care appointments, to pick up prescriptions, and to pick up medical supplies at no cost.
L.A. Care also covers transportation in emergency situations. Learn more about transportation coverage.
L.A. Care covers managed long term care services and supports for members who qualify.
Learn more about MLTSS services.
L.A. Care covers Enhanced Care Management (ECM) services for members with highly complex needs.
ECM is a benefit that provides extra services to help you get the care you need to stay healthy. It coordinates the care you get from different doctors.
Learn more about ECM services.
L.A. Care provides medically appropriate services and settings to address member’s health related social needs at no cost.
Learn more about CS services on our Community Health Services page.
L.A. Care offers no cost CHW services, which are preventive health services delivered by a CHW to prevent disease, disability, and other health conditions or their progression; to prolong life; and to promote physical and mental health.
Learn more about CHW services.
L.A. Care’s Community Resource Centers (CRCs) are jointly operated with Blue Shield of California Promise Health Plan and offer many free services and resources tailored to members and the communicated, related to health and wellness.
All CRC services are free and open to anyone in the community. Go to our Community Resource Center website for CRC location/addresses, telephone numbers, and hours of operations and calendar of events.
Prior Authorization
The following services do not require prior authorization if the member sees a Medi-Cal provider within the L.A. Care network:
- Basic prenatal care services
- Routine obstetrics services
- Pediatric preventative services
- Primary and preventative care services
- Biomarker testing for advanced metastatic stage 3 or 4 cancer or testing for cancer progression or recurrence in patients with advanced metastatic stage 3 or 4 cancer
- Mental health services (by L.A Care provider or county mental health plan provider)
The following services do not require prior authorization if the member sees a Medi-Cal provider outside of the L.A. Care network:
- Emergency services
- Urgent care visits if the member is outside the L.A. Care service area
- Sensitive services (which include family planning):
- Sexually transmitted disease services
- Abortion
- Minor consent services
- Human immunodeficiency virus (HIV) testing
View the document on how and when to obtain referrals and authorizations for specific services.