3 Main Medi-Cal Benefits You Need to Know

Caring for California residents for five decades, Medi-Cal is a health care program that provides free or affordable medical coverage for children, adults, and senior citizens who have low incomes and limited resources.

Essential health benefits


If you or a loved one is eligible for this health care program in California, you can enjoy a range of services in accordance with the Affordable Care Act that enjoins all Medi-Cal plans to provide the essential health benefits, including these general services:

  • Laboratory services
  • Outpatient services
  • Hospitalization
  • Emergency services
  • Prescription drugs
  • Care for pregnant woman and newborns – including baby products (ex: diapers, baby wipes or┬ábest shopping cart covers for babies)
  • Vision and oral health care for children
  • Behavioral treatment and other substance abuse disorder and mental health services
  • Management of chronic diseases
  • Occupational and physical therapy

Eye care benefits


For patients with full Medi-Cal benefits, vision benefits are included.

  • Medi-Cal members can avail of a routine eye exam every other year, including eyeglass prescription testing.
  • Coverage for frames and lenses are given only to nursing home patients and Medi-Cal members below 21 years old.
  • Patients with impaired vision that cannot be corrected by standard eyeglasses (or surgery or contact lenses) can avail of low-vision testing. Those whose eye health problems hinder their ability to do their day-to-day tasks, especially the elderly with age-related macular degeneration, can enjoy this benefit as well.
  • If an eye condition or health issue obstructs the use of glasses, Medi-Cal may cover contact lens testing.
  • For patients who have lost their eyes to an injury or disease, they can avail of artificial eye services and materials.

Dental benefits


Available for children and adults, the dental benefits cover the following services:

  • Cleanings
  • Fillings
  • Fluoride treatments
  • X-rays and exams
  • Full dentures
  • Prefabricated crowns
  • Root canals for the front teeth
  • Tooth decay treatment,┬áremineralize cavities and repair teeth naturally.
  • Other needed dental services

For an appointment, contact a Med-Cal health care provider, which you can find by checking the online directory of the California Department of Health Care Services website.