Medi-Cal

There are two common ways to receive Medi-Cal benefits:

  1. The first way is to have it administered directly by the state. This is usually referred to as Medi-Cal Fee For Service or “traditional Medi-Cal”.
  2. 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”.

Most counties are now using these Managed Medi-Cal plans. Typically, once you sign up for Medi-Cal, you are enrolled in 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.

View a list of the Managed Medi-Cal plans available by County.

Stanford Children’s Health is contracted and in-network with the following Medi-Cal options

Medi-Cal Fee For Service: (includes the Access for Infants and Mothers program)
Alameda Alliance for Health
Anthem Blue Cross
Central California Alliance for Health
Health Plan of San Joaquin
Health Plan of San Mateo
Partnership Health Plan
Santa Clara Family Health Plan
All Other Managed Medi-Cal Plans (including out of state Medicaid)

Medi-Cal Fee for Service (includes the Access for Infants and Mothers Program)

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford accept Medi-Cal Fee For Service for all hospital and physician services.

 

Alameda Alliance for Health

Stanford Children’s Health is in-network for hospital and all specialist physician services. Certain Stanford Children’s Health pediatricians in the East Bay, through affiliation with select medical groups may be selected as primary care physicians. Please check your health plan website for primary care physician availability.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Anthem Blue Cross

Stanford Children’s Health is in-network for hospital and all specialist physician services. Certain Stanford  Children’s Health pediatricians in the East Bay, through affiliation with select medical groups may be selected as primary care physicians. Please check your health plan website for primary care physician availability.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Central California Alliance for Health

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital services, all specialist physician services, and primary care services at our Monterey location.

In order to be seen at Stanford Children’s Health, your primary care physician would need to refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Health Plan of San Joaquin

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and specialist physician services.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Health Plan of San Mateo

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital services and specialist physician services.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Partnership Health Plan

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and specialist physician services.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Santa Clara Family Health Plan

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and specialist physician services.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

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 Children’s Health 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 Children’s Health. Once your health plan has authorized the care, they will reach out to negotiate a single case agreement with our Managed Care Department.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org