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On January 1, 2024, Kaiser Permanente will have a Medi-Cal contract with the California Department of Health Care Services (DHCS) in your county. You no longer have to enroll in another Medi-Cal health plan first, to get coverage and care from Kaiser Permanente providers.
Medi-Cal Changes for Members Assigned to Kaiser Permanente Through Another Health Plan
The California Department of Health Care Services (DHCS) has entered into an agreement with Kaiser Permanente to provide Medi-Cal coverage and care across much of the state under a single, direct contract starting January 1, 2024.
If you are a Kaiser Permanente Medi-Cal member, but enrolled through another health plan, you do not need to do anything to stay with Kaiser Permanente. You will be automatically enrolled with Kaiser Permanente as your Medi-Cal health plan on January 1, 2024.
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Frequently Asked Questions
No, this does not change anything about how you qualify for Medi-Cal. This also does not change your Medi-Cal Rx or Fee-for-Service benefits. There is no need to call your eligibility worker unless you need to update your personal information with the county. You can find a listing of county offices at https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx.
Nothing. If you want to move to our Medi-Cal Plan, you do not need to do anything. On January 1, 2024, you will be automatically enrolled with Kaiser Permanente for your Medi-Cal coverage.
No, your Medi-Cal benefits will not change. There will be no change in the services you receive from our Medi-Cal network providers. You can continue to get your Medi-Cal services from the same Kaiser Permanente providers.
For members in San Mateo County only:
On January 1, 2024, your Medi-Cal dental coverage will move to Medi-Cal Dental Fee-for-Service. For more information on your dental coverage options, call Medi-Cal Dental at 1-800-322-6384 (TTY 1-800-735-2922), Monday through Friday, 8 a.m. to 5 p.m. Or visit their website at https://smilecalifornia.org/.
Health Care Options supports enrollments for the California Department of Health Care Services (DHCS). They provide information about managed care plans so you can make an informed decision about your Medi-Cal benefits. Call Medi-Cal Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or go to https://www.healthcareoptions.dhcs.ca.gov/.
Yes, if you choose to stay with Kaiser Permanente, you will keep your Kaiser Permanente PCP. However, if you choose to stay with your 2023 Medi-Cal health plan you may need to choose a new provider network. Kaiser Permanente providers may not be an option. Your providers may change. You will need to call Medi-Cal Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or go to https://www.healthcareoptions.dhcs.ca.gov/.
You can continue to receive your Medi-Cal services from the same Kaiser Permanente providers. Some services may require a referral from your primary care physician. If you are receiving services from a provider who is not part of our Medi-Cal provider network, you may be able to continue to see that provider for up to 12 months. This is called continuity of care. For more information on continuity of care, call Kaiser Permanente Member Services at 1-855-839-7613 (TTY 711), 24 hours a day, 7 days a week.
You may be able to stay with your 2023 health plan, depending on where you live. You may need to choose a new provider network because our Kaiser Permanente provider network may not be an option with your 2023 plan. Your providers may change. You will need to call Medi-Cal Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or go to https://www.healthcareoptions.dhcs.ca.gov/.
To switch to another health plan, call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or visit https://www.healthcareoptions.dhcs.ca.gov/.
You received a new ID card to show the Medi-Cal Rx customer service phone number. Your Medi-Cal benefits are not changing. Your Medical Record Number (MRN) has not changed.
For former LA Care members: Because your Medi-Cal with Kaiser Permanente is no longer through LA Care, your ID Card no longer has the LA Care logo.
For the time being, please keep your 2023 Medi-Cal health plan membership card, your Kaiser Permanente membership card, and your Medi-Cal Beneficiary Identification Card (BIC).
After January 1, 2024, there could be times when you need to contact your old Medi-Cal health plan. You should keep your old Medi-Cal health plan membership card in case you need it in the future. Note: you will not need your old Medi-Cal health plan membership card to access services at Kaiser Permanente.
You will need both your Kaiser Permanente membership card and your Medical-Beneficiary ID card when you are at a Kaiser Permanente medical office or pharmacy. This will be important to make sure your benefits are processed correctly.
If you receive services from a provider who is not part of Kaiser Permanente’s Medi-Cal provider network, you may be able to continue seeing that provider for up to 12 months. This is called continuity of care. You may qualify for continuity of care if:
- You have a qualifying medical condition, or
- You are part of a special population, and
- You saw this provider at least once in 2023, and
- The provider is eligible to participate in Medi-Cal, and
- The provider accepts our contract rates
To learn more about continuity of care, call Kaiser Permanente Member Services at 1-855-839-7613 (TTY 711), 24 hours a day, 7 days a week.
No. This does not change your Medicare coverage, your Medicare providers, or your Medicare benefits.
In some counties, Medi-Cal Health Care Options may change your Medi-Cal plan to match your Medicare plan. For more information on the state’s matching plan policy, call Medi-Cal Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or go to https://www.healthcareoptions.dhcs.ca.gov/.
For members who were part of the Health Plan of San Mateo, Partnership HealthPlan, and CalOptima and choose to stay with Kaiser Permanente for Medi-Cal coverage:
Starting on January 1, 2024, you will automatically be enrolled in Kaiser Foundation Health Plan, Inc. for both your Medi-Cal and WCM services, including transportation and travel expenses related to WCM.
The change in your Medi-Cal coverage does not affect:
- Your eligibility for Medi-Cal
- Your Medi-Cal benefits
- Your eligibility for WCM and California Children’s Services (CCS)
You should have received a separate notice about the change in your Medi-Cal coverage and WCM program. If you did not receive these notices, please call Kaiser Permanente Member Services toll-free at 1-855-839-7613 (TTY 711), 24 hours a day, 7 days a week.
If you have questions about this change, call Kaiser Permanente Member Services at 1-855-839-7613 (TTY 711), 24 hours a day, 7 days a week.
The Medi-Cal Ombudsman can help you with concerns, complaints, or grievances. You can call the Medi-Cal Ombudsman at 1-888-452-8609 Monday through Friday 8 a.m. to 5 p.m. The call is free. Or email MMCDOmbudsmanOffice@dhcs.ca.gov.