Our Services

The benefits offered by the plan (including applicable conditions and limitations), with information about how to access services whose eligibility and assessments are conducted outside of the plan; Grievances, organization and coverage determinations, and appeals (contains sufficient information about the types of grievances and appeals available, how to initiate the appeals and grievances, and how to obtain assistance with the appeal or grievance).

Medi-Cal Rx – Action Required: Enroll as a Medi-Cal Provider

Effective June 26, 2026, in order for a Medi-Cal Rx enrolled pharmacy to dispense medication you prescribed to a Medi-Cal member, you must be enrolled in Medi-Cal Fee-for-Service (FFS) using your Type 1 National Provider Identifier (NPI).
» Beginning June 26, 2026, claims and PAs will not be processed by Medi-Cal Rx if you are not enrolled in Medi-Cal FFS with a Type 1 NPI.
Immediate Next Steps
As a prescriber, confirm your enrollment as a Medi-Cal FFS provider using the Enrolled FFS Providers list on the California Health and Human Services Open Data Portal. Once on the page, scroll down to the search field on the right and enter your NPI to verify your enrollment status. If you are enrolled, no further action is required. However, if you are not enrolled, you must initiate an account and an application to avoid possible pharmacy claims denials.
Enroll as a Medi-Cal provider through PAVE:

1. Navigate to the PAVE Provider Portal (https://pave.dhcs.ca.gov/sso/login.do) and create a new account.

2. Once you have created an account, select Application.

3. Fill out the application and ensure all required documentation is attached.

» Applications can take up to 90-180 days to be processed. Incomplete or inaccurate application information can delay processing time.

Please click here for more instruction about to enroll.

09/2025: Medi-Cal Redetermination.

During the COVID-19 Public Health Emergency, the federal government paused Medicaid eligibility verifications. This process is known as redetermination. Roughly 13 million Medi-Cal members stayed enrolled during this time without re-certifying their eligibility. Now, the state of California is resuming this requirement, starting April 1, 2023.

Please talk with your Medi-Cal patient about taking the steps below:

  • Update their contact information – Make sure their mailing address, phone number and email address are current.
    • Los Angeles County members can update their information by calling the Los Angeles County Department of Public Social Services at 1-866-613-3777 (TTY) 1-800-600-4026, or by going to benefitscal.com or visit KeepMediCalCoverage.org for more information and to sign up for text or email updates on Medi-Cal renewals.
    • Orange County members can update their information by calling the County of Orange Social Services Agency at 1-800-281-9799 or by going to MyBenefitsCalWIN.org
  • Sign up for updates – Create or check their online account to get general updates about Medi-Cal renewals through email and text messages.
  • Check their mailbox – Look out for a letter from the local county office about their Medi-Cal coverage. If they get a renewal form, fill it out and return it right away by mail, phone, in person or online.

Below are links to the CalOptima (English, Spanish, and Vietnamese) and Health Net (currently English only) member facing Flyers regarding Redetermination.

CalOptima Redetermination – English
CalOptima Redetermination – Spanish
CalOptima Redetermination – Vietnamese
Health Net Redetermination for Provider
Health Net Redetermination for Member