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Oct 22, 2024 · Managed care plans are a cost-effective use of health care resources that improve health care access and assure quality of care. Today, approximately 15.2 million Medi-Cal members in all 58 counties receive their health care through five main models of managed care: Two-Plan, County Organized Health Systems (COHS), Geographic Managed Care (GMC), Regional Model (RM), and Single-Plan.
- Auto Assignment Incentive Program
The California Department of Health Care Services (DHCS) has...
- Medi-Cal Managed Care Quality Awards
Medi-Cal Managed Care Quality Awards On an annual basis, the...
- 072915Meeting
Please do not enter any personal, medical, or confidential...
- Managed Care Final Rule
In California, the 2016 Final Rule regulations are...
- Types of Plans
Medi-Cal is health care for people with low or no incomes....
- Auto Assignment Incentive Program
In California, the 2016 Final Rule regulations are applicable to Medi-Cal Managed Care Plans, County Mental Health Plans, Drug Medi-Cal Organized Delivery System, and Dental Managed Care Plans. This webpage contains posting requirements for the Quality Strategy, Network Adequacy, and Mental Health Parity components of the 2016 Final Rule.
Nov 8, 2024 · You can enroll in a Medi-Cal health plan by phone. Call Medi-Cal Health Care Options Monday– Friday, 8 a.m. to 6 p.m. at (800) 430-4263 (TTY: (800) 430-7077). Or enroll online at www.healthcareoptions.dhcs.ca.gov. For people with both Medicare and Medi-Cal, Medi-Medi Plans are available in certain counties for voluntary enrollment.
- HMO
- PPO, Pos & EPO
- Medi-Cal Managed Care Plans
- Medicare Advantage Plans
An HMO is a health maintenance organization. The Department of Managed Health Care (DMHC) oversees all HMOs in California and some other kinds of health plans. 1. An HMO is a kind of health insurance that has a list of providers, such as doctors, medical groups, hospitals, and labs. You must get all of your health care from the providers on this li...
A PPOis a preferred provider organization. A PPO is good plan for people who want to see providers without prior approval from their health plan or medical group and who do not want to choose a primary care doctor. You get most of your health care from a network of doctors and other providers. You can choose to go outside of the network for some ca...
Medi-Cal is health care for people with low or no incomes. Some people who have Medi-Cal are in a Medi-Cal Managed Care plan. These plans have networks of providers, including doctors, pharmacies, clinics, labs, and hospitals. Medi-Cal covers the basic benefitsthat all health plans cover. Medi-Cal also covers prescription drugs, vision care, and he...
Medicare is a national health insurance program for seniors or those with disabilities. Medicare Advantage is Medicare's managed care program. If you join Medicare Advantage, you get all your care through an HMO or PPO that has a contract with Medicare. Anyone who has Medicare can get free help with forms, problems, and questions. Call HICAP (Healt...
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California. The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting consumers to resolve disputes with their health plans.
Sep 9, 2024 · The California Association of Health Plans is active in a variety of state regulatory activities. California state government agencies submit hundreds of proposed actions each year to adopt, amend, and repeal regulations. CAHP follows the regulatory actions of the California Department of Managed Health Care (DMHC), the California Department of Health Care Services (DHCS), the Office of the ...
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Jan 16, 2024 · Managed Health Care (DMHC) licenses and regulates most Medi-Cal Managed Care plans. The State of California relies on Managed Care plans to provide comprehensive health coverage to 14.1 million Californians, or 4 out of 5 Medi-Cal enrollees. Consumers face no out-of-pocket costs, and most pay no monthly premiums. Medi-Cal rates are set by the ...
