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Medi-Cal

Medi-Cal is a program that offers 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:

Medi-Cal which is administered directly by the state. This is usually referred to as Medi-Cal Fee-For-Service (FFS) or traditional Medi-Cal.
Medi-Cal benefits which are administered by a third-party insurance plan that your county 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 to 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 Tri-Valley is in-network with the following Medi-Cal options.

Medi-Cal Fee-For-Service/Traditional Medi-Cal

Stanford Health Care Tri-Valley accepts Medi-Cal Fee-For-Service for hospital services.

Alameda Alliance

Stanford Health Care Tri-Valley accepts Medi-Cal Fee-For-Service for hospital services.

Central California Alliance for Health

Stanford Health Care Tri-Valley is in-network for hospital services.

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

Kaiser

Kaiser members must obtain a referral from their Kaiser primary care or specialist physician and an authorization from their health plan for any service to be covered and considered in-network at Stanford Health Care Tri-Valley.

Partnership Health Plan - Bariatric Services Only

Stanford Health Care Tri-Valley is contracted with Partnership Health Plan - Bariatric Services only. Any other service would require an authorization from your health plan in order to be covered and considered in-network.

Health Plan of San Joaquin - Bariatric Services Only

Stanford Health Care Tri-Valley is contracted with Health Plan of San Joaquin - Bariatric Services only. Any other service would require an authorization from your health plan in order to be covered and considered in-network.

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 Tri-Valley 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 Tri-Valley.