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.
Stanford Health Care – ValleyCare accepts Medi-Cal Fee-For-Service for hospital services.
Stanford Health Care – ValleyCare accepts Medi-Cal Fee-For-Service for hospital services.
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 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.
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.
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.
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.
Patient Rights and Protections
Assess Your Coverage
Determine the extent of your coverage or any out-of-pocket costs before you receive care.
Contact: Financial Counseling
Phone: 925-534-6457
Mon – Fri: 8:00 a.m. – 5:30 p.m.
Sat – Sun: 7:30 a.m. - 4:00 p.m.
Insurance Pre-Authorization
Find out if your insurance carrier has pre-authorized a medical service before you receive care.
Contact: Financial Clearance
Phone: 650-724-4445
Toll Free: 1-877-291-7335