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The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
In the 1980s, as Medicaid managed care expanded across the county, safety net providers, such as Community Health Centers (CHCs) and public hospitals, feared that managed care would reduce reimbursements for Medicaid-eligible services, making it more difficult for them to provide care to the un- and under-insured, and result in a loss of Medicaid volume, as beneficiaries would choose to see ...
Of the 5.4 million Californians who gained health insurance coverage during this period, 1.4 million received coverage through Covered California, and 4.1 million received coverage from the expansion of Medi-Cal. [30] The number of individuals covered through the exchange has not increased significantly from the 1.4 million who enrolled during ...
Blue Shield of California is a mutual benefit corporation and health plan [6] [7] founded in 1939 by the California Medical Association. It is based in Oakland, California, and serves 4.5 million health plan members and more than 65,000 physicians across the state. Blue Shield of California was founded as a not-for-profit organization.
The program, administered by the Los Angeles County Department of Health Services (LADHS), was a Low Income Health Program (LIHP) approved under the Section 1115 Medicaid Waiver. [1] HWLA was succeeded by My Health LA , a no-cost health care program which ran from 2014 until 2024, when access to Medi-Cal was expanded.
Under an HCBS waiver, states can use Medicaid funds to provide a broad array of non-medical services (excluding room and board) not otherwise covered by Medicaid, if those services allow recipients to receive care in community and residential settings as an alternative to institutionalization. [1]
Open network plans provide some coverage when an enrollee uses non-network provider, generally at a lower benefit level to encourage the use of network providers. Most preferred provider organization plans are open-network (those that are not are often described as exclusive provider organizations, or EPOs), as are point of service (POS) plans.