This section explains your covered services as a member of L.A. Care.
Your covered services are free as long as they are medically necessary and provided by an in-network provider.
You must ask us for pre-approval (prior authorization) if the care is out-of-network except for certain sensitive services and emergency care.
Your health plan might cover medically necessary services from an out-of-network provider, but you must ask L.A. Care for pre-approval (prior authorization) for this.
Medically necessary services are reasonable and necessary to protect your life, keep you from becoming seriously ill or disabled, or reduces severe pain from a diagnosed disease, illness or injury.
For Members under the age of 21, Medi-Cal services include care that is medically necessary to fix or help relieve a physical or mental illness or condition.
For more on your covered services, call Member Services at 1-888-839-9909 (TTY 711)
Members under 21 years old get extra benefits and services.
To learn more, visit the Child and Youth Well Care section of this handbook for more information.
Some of the basic health benefits L.A. Care offers are listed below. Benefits with a star (*) may need pre-approval.
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Definitions and descriptions of covered services can be found in the Words to Know section of this handbook