Medi-cal health benefit
| Nhom | Services |
| Ambulatory Patient Services | Allergy care Dialysis/hemodialysis Chiropractic Hospital outpatient & outpatient clinic services Outpatient surgery (includes anesthesiologist services.) Physician services Podiatry Treatment therapies (chemotherapy, radiation therapy, etc.) |
| 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. |
| Emergency Services | Emergency Room services 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 Ambulance services |
| Hospitalization | Inpatient hospital services Anesthesiologist services Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation |
| Laboratory Services | Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity |
| Long Term Services and Supports | Skilled Nursing Facility services (91+days) Personal Care Services Self-Directed Personal Assistance Services Community First Choice Option Home and Community Based Service |
| Maternity and Newborn Care | Prenatal care Delivery and postpartum care Breastfeeding education Nurse midwife services |
| Mental health and Substance Use Disorder (SUD) Services, including Behavioral Health Treatment | Outpatient Mental Health services Outpatient Specialty Mental Health services Inpatient Specialty Mental Health services Outpatient Substance Use Disorder services o 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 |
| Preventive and Wellness Services and Chronic Disease Management | Preventive services and vaccines recommended by: o United States Preventive Services Task Force (grade A & B) o Advisory Committee for Immunization Practices o Health Resources and Services Administration’s Bright Futures o The Institute of Medicine preventive services (for women) Family planning services Smoking cessation services Behavioral health treatment for children under 21 |
| Rehabilitative & Habilitative Services and Devices | Physical therapy Occupational therapy Speech therapy / Audiology Acupuncture Cardiac rehabilitation Pulmonary rehabilitation Skilled Nursing Facility services (90 days) Laboratory Services Medical supplies, equipment, and appliances (including implanted hearing devices) Durable medical equipment Orthotics/prostheses Hearing aids Home Health Services Outpatient laboratory and X-ra |
| Transportation Services | Nonemergency medical 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 covered benefit. Nonmedical transportation by private or public vehicle for people who do not have another way to get to their appointment. |
| Vision | Routine eye exams once in 24 months Eyeglasses and contact lenses |
