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Medi-Cal

Medi-Cal is a program that offers health coverage for children and adults with limited income and resources. Find out if you qualify for Medi-Cal.

There are two common ways to receive Medi-Cal benefits:

Medi-Cal which is administered directly by the state. This is usually referred to as Medi-Cal Fee-For-Service (FFS) or traditional Medi-Cal.
Medi-Cal benefits which are administered by a third-party insurance plan that your county has chosen to administer those benefits for its residents. This is referred to as Medi-Cal HMO or Managed Medi-Cal.

Typically, once you sign up for Medi-Cal, you are enrolled in a traditional Medi-Cal FFS plan for the first 30 days, and then the state transitions you to one of the Managed Medi-Cal plans available in your county. Most counties in California are now using Managed Medi-Cal plans.

Medi-Cal HMO or Managed Medi-Cal Plan Options

Stanford Health Care – ValleyCare is in-network with the following Medi-Cal options.

Medi-Cal Fee-For-Service/Traditional Medi-Cal

Stanford Health Care – ValleyCare accepts Medi-Cal Fee-For-Service for hospital services.

Alameda Alliance

Stanford Health Care – ValleyCare accepts Medi-Cal Fee-For-Service for hospital services.

Central California Alliance for Health

Stanford Health Care – ValleyCare is in-network for hospital services.

In order to be seen at Stanford Health Care – ValleyCare, your primary care physician or specialist physician would need to refer you and your medical group or health plan would need to authorize all services provided at Stanford Health Care – ValleyCare.

Kaiser

Kaiser members must obtain a referral from their Kaiser primary care or specialist physician and an authorization from their health plan for any service to be covered and considered in-network at Stanford Health Care – ValleyCare.

Partnership Health Plan - Bariatric Services Only

Stanford Health Care – ValleyCare is contracted with Partnership Health Plan - Bariatric Services only. Any other service would require an authorization from your health plan in order to be covered and considered in-network.

Health Plan of San Joaquin - Bariatric Services Only

Stanford Health Care – ValleyCare is contracted with Health Plan of San Joaquin - Bariatric Services only. Any other service would require an authorization from your health plan in order to be covered and considered in-network.

All Other Managed Medi-Cal Plans (including Medicaid plans from other states)

If your Medi-Cal plan is not included on the list of in-network plans, that means that Stanford Health Care – ValleyCare does not have a contract with your plan. Some Medi-Cal/Medicaid plans are willing to authorize treatment on a case by case basis. It is recommended that you work with your primary care physician to obtain a referral/authorization for treatment at Stanford Health Care – ValleyCare.