All inpatient and outpatient services that are necessary for the treatment of an emergency medical condition, including dental services, as certified by the attending physician or other appropriate provider.
Mental health and Substance Use Disorder (SUD) Services
Outpatient mental health services
Outpatient specialty Mental health services
Inpatient specialty mental health services
Outpatient substance use disorder services
Residential treatment services
Voluntary inpatient detoxification
Prescription Drugs
Coverage is at least the greater of one drug in each U.S. Pharmacopeia (USP) category and class.
Beneficiaries may receive up to a 100-day supply of many medications.
Programs such as physical and occupational therapy (known as Rehabilitative & Habilitative Services) and devices
Physical therapy
Speech therapy / Audiology
Occupational therapy
Acupuncture
Cardiac rehabilitation
Pulmonary rehabilitation
Skilled nursing facility services (90 days)
Medical supplies, equipment and appliances (including implanted hearing devices)
Durable medical equipment
Orthotics/prostheses
Hearing aids
Home Health Services
Laboratory Services
Outpatient laboratory and X-ray services
Various advanced imaging procedures are covered based on medical necessity.
Preventive and Wellness Services and Chronic Disease Management
United States Preventive Services Task Force A & B recommended preventive services
Advisory Committee for Immunization Practices recommended vaccines
Health Resources and Service Administration’s Bright Futures recommendations
Preventive services for women recommended by The Institute of Medicine
Family planning services
Smoking cessation services
Behavior health treatment for children under 21
Pediatric Services Including Oral and Vision Care
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) is a Medi-Cal benefit for individuals under the age of 21 who have full-scope Medi-Cal eligibility. EPSDT provides periodic screenings to determine health care needs and, in addition to the standard Medi-Cal benefits, a beneficiary under the age of 21 may receive extended services as medically necessary.
Other
Dental
Emergency dental services
Dentures
Dental implants and implant-retained prostheses
Basic preventive, diagnostic, and repair services
EPSDT and pregnant women receive extended dental benefits.
Vision
Routine eye exam once in 24 months
Eyeglasses and contact lenses
Transportation Services
Medi-Cal offers transportation to and from appointments for services covered by Medi-Cal. This includes transportation to medical, dental, mental health, or substance use disorder appointments, and to pick up prescriptions and medical supplies.
Nonemergency Transportation Services: Transportation by ambulance, litter van, or wheelchair van only when ordinary public or private conveyance is medically contra-indicated and transportation is required for a Medi-Cal benefit.
Nonmedical Transportation Services: Transportation by private or public vehicle for people who do not have another way to get to their appointment.