Is L.A. Care a PPO or HMO?
Asked by: Dr. Enrique Grimes | Last update: July 22, 2025Score: 4.3/5 (66 votes)
What type of plan is a L.A. Care Health Plan?
L.A. Care offers a Medi-Cal plan built with our community in mind.
What type of insurance is Medi-Cal HMO or PPO?
Almost all Medi-Cal plans are "managed care plans" which means they function similar to an HMO. Medi-Cal Plans can be found in the Medi-Cal Managed Care Health Plan Directory. A managed care plan means you'll have a primary care physician, and they're the one person you'll see if you need medical care.
What network is LA Care covered?
The Medi-Cal provider network is the group of doctors, hospitals and other providers that work with L.A. Care to provide Medi-Cal covered services to Medi-Cal members. L.A. Care is a managed care health plan. You must get most of your covered services through L.A. Care in-network providers.
What is L.A. Care Medi-Cal Group?
L.A. Care Health Plan is the nation's largest publicly operated health plan serving. Its mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income residents and to support the safety net required to achieve that purpose.
What is an HMO, PPO, HDHP or EPO
Is L.A. Care HMO good?
L.A. Care offers one of the largest HMO provider networks in the Covered California marketplace. Each plan provides comprehensive benefits and $0 preventive services to help you achieve your health goals.
Which Medi-Cal plan is best?
OAKLAND, Calif., Jan. 19, 2023 – Kaiser Permanente Northern California's Medi-Cal health plan is the highest rated in the state for quality care, according to a December 2022 report from the state's Department of Health Care Services (DHCS).
Is L.A. Care only for low income?
The Local Initiative Health Authority for Los Angeles County (L.A. Care) is a public agency that provides health insurance for low-income individuals in Los Angeles County through four health coverage programs including Medi-Cal.
Can I go to any doctor with L.A. Care?
The doctor you choose must be an in-network provider. To get a copy of the L.A. Care Provider Directory, download it from the Medi-Cal Member Materials page or call Member Services at 1-888-839-9909 (TTY: 711) to have one sent to you.
Is Blue Cross part of L.A. Care?
Medi-Cal Managed Care (Medi-Cal)
are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.
How do I know if I have PPO or HMO?
However, if you've already got a health plan and don't know which plan type you have, you can check your insurance card or contact your insurance provider directly. If you have an online account through your provider that allows you to access plan details, you can also start there.
Is L.A. Care the same as Covered California?
L.A. Care is one of 12 carriers offered on California's State Exchange - Covered California. Coverage is provided in the Southwest and Northeast Los Angeles county pricing regions.
Do doctors prefer HMO or PPO?
HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.
How does L.A. Care HMO work?
L.A. Care is a managed care health plan contracted with DHCS. L.A. Care works with doctors, hospitals, and other health care providers in the L.A. Care service area to give health care to our members. As a member of L.A. Care, you may qualify for some services provided through FFS Medi-Cal.
Is L.A. Care a Medicare Advantage plan?
It's a Medicare Advantage health plan, which provides specialized care and wrap-around services for dual eligible beneficiaries (eligible for both Medicare and Medi-Cal). L.A. Care Medicare Plus is here to deliver coordinated and seamless healthcare that supports your health and independence.
Does L.A. Care cover gym memberships?
SilverSneakers® is a no-cost fitness benefit for L.A. Care Medicare Plus members. This exciting program gives you a free basic gym membership at more than 15,000 fitness center locations across the country.
What type of plan is L.A. Care Medi-Cal?
L.A. Care Medi-Cal is the largest Medi-Cal plan in California that provides health care coverage to Medi-Cal beneficiaries residing in Los Angeles County.
Why do some doctors not accept Medi-Cal?
Why doctors say they don't see Medi-Cal patients. While low reimbursement rates are the most common reason California doctors say they limit the number of Medi-Cal patients they see, the program's administrative burden is also daunting. Source: California Health Care Foundation.
Does L.A. Care cover CT scans?
We do not cover any other Services related to the dental procedure, such as the dentist's Services. All other CT scans, and all MRIs and PET scans are covered.
How good is a L.A. Care Health Plan?
L.A. Care Health Plan is the highest-rated Medi-Cal managed care plan in Los Angeles County, as shown by the National Committee for Quality Assurance's (NCQA) Medicaid Health Insurance Plan Ratings 2019–2020.
What disqualifies you from Medi-Cal?
To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have countable income less than 250% of the federal poverty level (in 2024, this equates to $3,158/mo.
Is Kaiser part of L.A. Care?
In addition to offering a direct Medi-Cal line of business, L.A. Care contracts with three Plan Partners to provide coverage to Medi-Cal members. These Partners are Anthem Blue Cross, Care 1st Health Plan, and Kaiser Permanente.
What is the best PPO insurance?
Best PPO health insurance: Blue Cross Blue Shield (BCBS)
Large selection of doctors: The Blue Cross Blue Shield network includes 90% of the country's doctors and hospitals. The exact doctor network varies by plan, but BCBS typically gives you the most flexibility about where you get medical care.
Is L.A. Care free?
Member Costs
L.A. Care serves people who qualify for Medi-Cal. In most cases, L.A. Care members do not have to pay for covered services, premiums or deductibles. If you are an American Indian, you do not have to pay enrollment fees, premiums, deductibles, co-pays, cost sharing, or other similar charges.
Can I get Kaiser with Medi-Cal?
The California Medi-Cal program provides health care coverage for some of the most vulnerable populations in the state and Kaiser Permanente participates in the Medi-Cal program to provide high quality care to enrolled beneficiaries in most counties currently served by the health plan.