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Health Insurance Plans: Medi-Cal

Medi-Cal is a program that offers free or low-cost 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:

The first way is to have it administered directly by the state. This is usually referred to as Medi-Cal Fee-For-Service (FFS) or traditional Medi-Cal.
The other way is that your Medi-Cal benefits are administered by a third-party insurance plan that your county of residence 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 into 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 is in-network with the following Medi-Cal options.

Medi-Cal Fee-For-Service

Stanford Health Care accepts Medi-Cal Fee-For-Service for all hospital and physician services.

Central California Alliance for Health

Stanford Health Care is in-network for hospital and specialist physician services only. You would not be able to select a Stanford Health Care physician as your primary care physician.

In order to be seen at Stanford Health Care, your primary care physician would need to refer you and your medical group or health plan would need to authorize all services provided at Stanford Health Care or by Stanford Health Care physicians.

Health Plan of San Mateo

Stanford Health Care is in-network for all hospital and specialist physician services only. You would not be able to select a Stanford Health Care physician as your primary care physician.

Partnership Health Plan

Stanford Health Care is in-network for hospital and specialist physician services only. You would not be able to select a Stanford Health Care physician as your primary care physician.

Santa Clara Family Health Plan

Stanford Health Care is in-network for hospital and specialist physician services only. You would not be able to select a Stanford Health Care physician as your primary care physician.

All Other Managed Medi-Cal Plans (including Medicaid plans from other states)

If your Medi-Cal plan is not included on the list of in-network plans, that means that Stanford Health Care 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. Once your health plan has authorized the care, they will reach out to Stanford Health Care to negotiate a single case agreement with our Managed Care Department.