Plans and Coverage

Overview

Medi-Cal Managed Care

California’s Medicaid program (“Medi-Cal”) offers coverage to eligible beneficiaries through either the fee-for-service delivery system or through managed care. Medi-Cal managed care is available in all 58 of California’s counties, and most Medi-Cal beneficiaries are required to enroll in a managed care plan.

California has over 14 million people enrolled in Medi-Cal, of which 10.6 million are Medi-Cal managed care beneficiaries. Over 70% (7.5 million) of Medi-Cal managed care beneficiaries receive their health care coverage through LHPC’s member plans. Our member plans represent all of the publicly-governed Medi-Cal health plans and cover more lives than 49 other states’ entire Medicaid programs.

Within the Medi-Cal managed care program, depending on the beneficiary’s county of residence the state uses one of four different models to deliver care:

  • County Organized Health System (COHS) model
  • Geographic Managed Care (GMC) model
  • Regional model
  • Two-Plan model

LHPC member plans participate in the COHS, GMC and Two-Plan models.

Commands