Cost and Benefits

Cost

You do not have to pay for covered services. Your covered services are at no cost to you if they are medically necessary and provided by a Partnership provider. For a list of covered services, go to "Benefits and services" of the Member Handbook (click here).

You have to get prior authorization (pre-approval) before you visit a provider outside of our network. If you do not get
pre-approval you may have to pay for services. This does not apply to emergency or sensitive services. Sensitive services include:

    • Pregnancy testing and counseling
    • HIV/AIDS prevention and testing
    • Sexually transmitted infections testing and treatment
    • Sexual assault care
    • Outpatient abortion services

For more information about sensitive services see the "Sensitive care" section of the Member Handbook (click here).

Visit our Provider Directory for a list of Partnership providers (click here).

Long-term care and a share of cost

You may have to pay a share of cost each month for your long-term care services. Your share of cost depends on your income and resources. This cost is decided by your local Medi-Cal office. Each month you will pay up to your share of cost amount for your own health care. After that, your benefits and services will be covered by Partnership.

Benefits

Routine and preventive care are covered services, as well as medically necessary services when given by a Partnership provider. Routine care helps you stay healthy and helps keep you from getting sick. Routine care includes preventive care. Preventive care includes routine checkups and helps prevent health problems or finds them before they become worse. Medically necessary services are reasonable services needed to protect your life, keep you from getting very ill or disabled, or reduces severe pain from a diagnosed disease, illness or injury.

Some services need pre-approval from your provider and Partnership.

Partnership covers the basic health benefits and services listed below. Click the benefit or service for more information including if a pre-approval is needed.

Members with Limited Medi-Cal

Coverage for some members only includes breast and cervical cancer treatment and/or long-term care services. This is decided by your local Medi-Cal office.

Visit your Member Handbook for a list of covered services (click here).

Unable to display this Web Part. To troubleshoot the problem, open this Web page in a Microsoft SharePoint Foundation-compatible HTML editor such as Microsoft SharePoint Designer. If the problem persists, contact your Web server administrator.


Correlation ID:0f1c3ea1-4067-9029-9078-5f2a9206be07
Unable to display this Web Part. To troubleshoot the problem, open this Web page in a Microsoft SharePoint Foundation-compatible HTML editor such as Microsoft SharePoint Designer. If the problem persists, contact your Web server administrator.


Correlation ID:0f1c3ea1-4067-9029-9078-5f2a9206be07