What is the process for choosing a Medi-Cal managed care plan after I have been approved for eligibility in California?

After your Medi-Cal eligibility is approved, you will receive a packet by mail prompting you to choose a managed care health plan within 30 days. If you do not actively choose a plan, the state will assign one to you automatically. Here is the process for selecting your plan: Step 1: Look for Your Enrollment Packet Within 45 days of your approval, you will receive a "New Medi-Cal Member Packet" from California's Health Care Options (HCO). This packet contains a comparison chart of the health plans available in your county and a choice form to make your selection. Step 2: Research Your Health Plan Options Use the comparison chart in your packet to review the different plans. Visit the Health Care Options website (www.healthcareoptions.dhcs.ca.gov) for more detailed information. Compare the plans based on their specific benefits, pharmacy networks, and available doctors and hospitals. Step 3: Confirm Your Doctors Are In-Network The most critical step is to check if your current doctors, specialists, or preferred hospitals are in the plan's network. Call your doctor’s office directly and ask, "Do you accept Medi-Cal, and are you in the [Health Plan Name] network?" Do not rely solely on the plan's online directory, as it may be outdated. Step 4: Make and Submit Your Choice Within 30 Days You have 30 days from the date on your enrollment letter to choose a plan. You can submit your choice in one of three ways: - Mail: Fill out the choice form from your packet and mail it in the provided envelope. - Phone: Call Health Care Options at (800) 430-4263. - Online: Visit the Health Care Options website and enroll online. Important Details and Nuances: If you do not choose a plan within 30 days, Medi-Cal will automatically assign you to a plan to ensure you have coverage. You generally have the option to change your health plan once a month for the first 90 days after enrollment. After that, you can typically only change plans during an annual open enrollment period or if you have a specific reason qualifying as "good cause." Note that some counties in California only have one managed care plan available, so you will not have a choice. Warnings and Limitations: Health plan provider directories are not always accurate. Always confirm directly with your doctor's office that they accept the specific plan you intend to choose before you enroll. The process and available plans vary significantly by county. This is general information and does not constitute legal advice. For complex situations, consult with a qualified California attorney.