What type of coverage is L.A. Care?
Asked by: Mrs. Stefanie Ziemann V | Last update: June 3, 2025Score: 5/5 (26 votes)
What kind of insurance is L.A. Care?
L.A. Care offers a Medi-Cal plan built with our community in mind. Medi-Cal is a public health care program for those with limited income. This free or low-cost public health insurance program pays for medical services for eligible California residents.
What network is L.A. 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 the difference between Medi-Cal and L.A. Care?
L.A. Care is the health plan for Medi-Cal members in Los Angeles County. The California Department of Health Care Services (DHCS) works with L.A. Care to provide your Medi-Cal health care.
Is Medi-Cal an 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.
Why and how L.A. Care Health Plan is tackling social determinants of health
How do I know if my insurance is 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 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.
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.
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 is the best Medi-Cal health plan in California?
Kaiser Permanente is also the only Medicare health plan in California to receive a 5-star rating, according to the Centers for Medicare & Medicaid Services' 2023 Medicare Star Ratings.
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.
Does L.A. Care cover ER visits?
Emergency care is covered at all times and in all places. If you're not sure if you should visit the Emergency Room and need advice, you can: Call the Nurse Advice Line 1-800-249-3619 (TTY 711) Call Member Services at 1-888-839-9909 (TTY 711)
Why is L.A. insurance so expensive?
There are many reasons why car insurance in Los Angeles is expensive, including the high number of cars on the road, population density and car accident and theft rates. Minimum-coverage car insurance in LA costs 49% more than the California average and 33% more than the national average.
What is the highest income to qualify for Medi-Cal?
You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($21,597 for an individual; $44,367 for a family of four).
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.
Is L.A. Care a PPO or HMO?
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.
What is the most expensive health insurance in California?
The most expensive health insurance in California is a platinum plan for an elderly adult, with an average monthly rate of $1982.
Does L.A. Care have a copay?
Aside from the monthly premium, you may be responsible for paying a charge when you receive a covered service. This charge is called a copayment and is outlined in the Summary of Benefits. If you review your Summary of Benefits, you'll see that the amount of the copayment depends on the service you receive.
Is L.A. Care Medi-Cal or Medicare?
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.
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.
How does L.A. Care 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.
What is the rating of L.A. Care?
NCQA works to improve health care quality through assessment of evidence-based standards, measures, and programs, and assignment of accreditation status. L.A. Care's rating jumped from 3.5 to 4 stars for 2019-2020.
Does Medicare Advantage pay hospital bills?
Medicare Advantage plans must cover all services covered by traditional Medicare under Part A (hospital services, some home health, hospice care, skilled nursing care) and Part B (physician services, durable medical equipment, outpatient drugs, mental health, ambulance services).