Medi-Cal provides healthcare coverage for low-income residents of California, ensuring that they can get the healthcare services they need. However, in many areas, including Upland, it can be a challenge to find a doctor who accepts Medi-Cal. It’s important to understand how to find a provider and what options are available.
What Is Medi-Cal and What Does It Cover?
Medi-Cal is the state of California’s version of Medicaid and is overseen by the Department of Health Care Services (DHCS). It is for low-income residents of California and their families, and makes no to low-cost health care coverage accessible to many people who cannot afford private health insurance.
Medi-Cal provides comprehensive coverage for many healthcare services, including:
- Basic Medical Care: Routine doctor visits, preventive care, hospital services, emergency services, lab tests, X-rays, prescription medications, and the treatment of chronic conditions.
- Dental Care (Denti-Cal): Exams, cleanings, X-rays, fillings, root canals, dentures, and some oral surgeries.
- Vision Care: Routine eye exams, coverage for eyeglasses or contact lenses, and treatment for eye diseases.
- Mental Health and Substance Use Services: Mental health and substance use disorder treatment, including outpatient therapy and counseling, psychiatric services, inpatient mental health care, and substance use disorder treatment programs.
- Pregnancy and Family Planning: Prenatal care, labor and delivery, postpartum care for up to 12 months. Family planning services, including birth control and reproductive health care, are also included.
- Children’s Benefits (EPSDT): Additional benefits for children through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program. This includes regular developmental screenings, vision and hearing services, behavioral health care, and therapies such as speech, occupational, and physical therapy.
- Transportation Services: Non-emergency medical transportation for members who need help getting to medical appointments.
- Long-Term and In-Home Care: For seniors and individuals with disabilities, provides long-term care services such as nursing home care and home health services.
Where to Start Your Search
A good first step is checking your Medi-Cal managed care plan’s provider directory. Many residents in the area are enrolled in plans like Inland Empire Health Plan or L.A. Care Health Plan, and each plan keeps an updated list of in-network doctors, clinics, and specialists. These directories are easy to search online and allow you to filter by location, provider type, and language preferences.
The California Department of Health Care Services also offers tools and information to help you understand your benefits and find participating providers.
Additionally, calling your health plan’s member services line can connect you with a representative who can walk you through your options, confirm which providers are in-network, and help you choose or switch your primary care doctor.
Consider Community Health Centers
Federally Qualified Health Centers (FQHCs), commonly known as community health centers, are community-based healthcare providers that receive federal funding to provide affordable healthcare and mental healthcare services to underserved and low-income populations, regardless of ability to pay. These health centers accept both Medi-Cal and Medicare.
Community health centers provide a host of services, including primary care, preventive care, chronic disease management, mental health services, substance use treatment, and sometimes dental and vision care.
Even for people without health care coverage, these centers have a sliding fee scale. Under a sliding fee scale, clinics calculate the amount the person pays by comparing their household income to the Federal Poverty Level, which is determined each year by the federal government. This means that patients whose income falls below a certain percentage of the Federal Poverty level may qualify for significantly reduced fees.
Choosing the Right Doctor
When choosing a provider, consider practical factors like how close the office is to your home in Upland and whether transportation is convenient. You also want a provider who speaks your preferred language. Also, consider what kind of services you need, such as family medicine, pediatrics, or mental health services, and whether those services are offered by that provider.
Additionally, look at their education, background, and experience, and check the state’s medical board website to ensure that they are board certified and in good standing.
What to Bring to Your First Appointment
For administrative reasons and to help you build your foundation of care, you’ll need to bring a few items with you to your first appointment. These include:
- Your driver’s license or ID
- Your health insurance card
- Your previous medical records (you can get these from your previous health care providers)
- A list of all medications that you take including over the counter medication and supplements
- A list of questions that you have for the doctor about current health conditions and medical concerns
In Closing
Several tools are available to help you find a doctor who accepts Medi-Cal near Upland, CA. If you or someone you know needs care and has Medi-Cal or is worried about cost, call our Euclid Community Health Center at 840-237-3344. The center is located at 600 N Euclid Ave. Ste. 202 Upland, CA 91786. At Health Service Alliance, we are dedicated to providing compassionate, personalized, and accessible care regardless of your ability to pay.
