Last Updated: September 1, 2026
What Does Medi-Cal Cover in California? 2026 Benefits Guide
Medi-Cal provides free or low-cost health coverage to eligible California residents and covers a wide range of medically necessary health care services.
Depending on your eligibility, age, health needs, and how you receive Medi-Cal, your benefits may include doctor visits, hospital care, prescription medications, preventive services, mental health care, dental and vision services, pregnancy care, transportation, and long-term services and supports.
If you are new to Medi-Cal and want to understand how the program works before reviewing individual benefits, read What Is Medi-Cal? A Beginner’s Guide .
Full-scope Medi-Cal covers most medically necessary health care. However, the exact way you receive a service can depend on whether it is handled by your Medi-Cal managed care health plan, Medi-Cal Rx, Medi-Cal Dental, your county behavioral health plan, or Fee-for-Service Medi-Cal.
Not every Medi-Cal member has exactly the same benefits. Restricted-scope Medi-Cal provides fewer services than full-scope Medi-Cal, and some benefits can depend on age, immigration-related eligibility, medical necessity, county, or health plan.
1. Doctor Visits and Outpatient Care
Medi-Cal covers medically necessary doctor and outpatient services.
Covered care can include:
- Primary care doctor visits
- Visits when you are sick or injured
- Specialist care
- Outpatient clinic visits
- Outpatient surgery
- Allergy treatment
- Dialysis and kidney treatment
- Certain cancer treatments such as chemotherapy and radiation
- Podiatry when covered and medically necessary
If you are enrolled in Medi-Cal managed care, you will usually receive routine medical care through doctors and specialists in your health plan's network.
If you are having trouble finding a provider, see How to Find a Doctor Who Accepts Medi-Cal for step-by-step guidance.
2. Hospital and Emergency Care
Medi-Cal covers medically necessary hospital services and emergency care.
- Emergency room care
- Hospital stays
- Inpatient surgery
- Outpatient surgery
- Intensive care when medically necessary
- Hospital physician services
- Other medically necessary inpatient treatment
For a true medical emergency, you should seek emergency care immediately. Emergency care is treated differently from routine care and generally does not require you to obtain a routine referral first.
3. Prescription Medications — Medi-Cal Rx
Most outpatient prescription drug benefits for Medi-Cal members are administered through Medi-Cal Rx rather than directly through the member's Medi-Cal managed care health plan.
Medi-Cal Rx covers eligible prescription medications and certain pharmacy-related benefits when Medi-Cal requirements are met.
- Many prescription medications
- Certain over-the-counter medications when covered
- Some medical supplies obtained through a pharmacy
- Certain enteral nutrition products
1-800-977-2273
TTY: California State Relay at 711
Some medications may require prior authorization or may have other coverage requirements.
4. Preventive and Wellness Care
Medi-Cal covers many preventive services designed to help detect health problems early and help members stay healthy.
- Routine checkups
- Vaccines and immunizations
- Blood pressure screening
- Diabetes screening
- Certain cancer screenings
- Cholesterol and other health screenings
- Chronic disease management
- Help to stop smoking
- Certain Community Health Worker preventive services
5. Mental Health Services
Medi-Cal covers mental health services ranging from outpatient care to more intensive specialty treatment.
- Mental health evaluations
- Individual therapy
- Group therapy
- Family therapy when covered
- Psychiatric services
- Medication-related mental health services
- Crisis services
- Specialty mental health treatment
Some non-specialty mental health services may be provided through your Medi-Cal managed care plan. More intensive Specialty Mental Health Services are provided or arranged through county Mental Health Plans for members who meet applicable criteria.
6. Medi-Cal Dental
Medi-Cal Dental covers a wide range of dental services for eligible members.
- Dental exams
- X-rays
- Cleanings
- Fillings
- Crowns when covered
- Root canal treatment
- Tooth extractions
- Scaling and root planing
- Periodontal maintenance
- Full and partial dentures
- Emergency dental treatment
- Orthodontic treatment for qualifying children
A planned reduction of non-emergency dental benefits for certain adult Medi-Cal members based on immigration-related eligibility has been delayed until July 1, 2027. Members should check DHCS for the latest rules before assuming their dental benefits have ended.
1-800-322-6384
TTY: 1-800-735-2922 or 711
Monday–Friday, 8 a.m.–5 p.m.
7. Vision Care
Medi-Cal covers vision services for eligible members. Benefits may include eye examinations, prescription eyeglasses, contact lenses when covered under Medi-Cal rules, low-vision evaluations, artificial eye services, and other medically necessary vision treatment.
For Fee-for-Service Medi-Cal, DHCS generally lists a routine eye examination and eyeglasses once every 24 months. Additional services can be available when medically necessary.
For more information, read Does Medi-Cal Cover Vision Services? .
8. Pregnancy, Maternity, and Newborn Care
Medi-Cal provides extensive pregnancy-related and maternity services for eligible members.
- Prenatal care
- Doctor and midwife services
- Labor and delivery
- Hospital care
- Postpartum care
- Newborn care
- Pregnancy-related testing
- Breastfeeding support and related services
- Doula services when program requirements are met
California also provides extended postpartum Medi-Cal coverage for eligible pregnant members for up to one year after the pregnancy ends.
For pregnancy eligibility, income rules, MCAP, household size, postpartum coverage, and application information, read Pregnancy Medi-Cal and MCAP in California: 2026 Guide .
If you recently had a baby, see Newborn Baby Medi-Cal: How to Get Health Coverage for Your Baby .
9. Laboratory, Imaging, and Diagnostic Services
Medi-Cal covers medically necessary laboratory and diagnostic services ordered as part of covered care.
- Blood tests
- Urine tests
- X-rays
- Ultrasounds
- MRI scans
- CT scans
- Other medically necessary diagnostic tests
10. Family Planning and Reproductive Health Services
Medi-Cal covers a range of family planning and reproductive health services, including birth control, family planning counseling, pregnancy testing, testing and treatment for sexually transmitted infections, and certain reproductive health services.
11. Transportation to Medi-Cal Services
Medi-Cal can provide transportation to and from covered Medi-Cal services, including certain medical, dental, mental health, substance use disorder, pharmacy, and medical supply services.
Non-Emergency Medical Transportation (NEMT)
NEMT is for members whose medical or physical condition prevents them from safely using ordinary public or private transportation.
Non-Medical Transportation (NMT)
NMT may be available to eligible Medi-Cal members who do not have another way to get to and from covered Medi-Cal services.
12. Substance Use Disorder Treatment
Medi-Cal covers treatment for substance use disorders. Depending on medical need and the program available in your county, services may include assessment, outpatient treatment, intensive outpatient services, residential treatment, withdrawal management, medication-assisted treatment, counseling, and recovery support services.
13. Rehabilitation, Therapy, and Medical Equipment
- Physical therapy
- Occupational therapy
- Speech therapy
- Home health services
- Wheelchairs
- Hospital beds
- Oxygen equipment
- Orthotics
- Prosthetic devices
- Other covered durable medical equipment and supplies
14. Long-Term Services and Supports
Medi-Cal covers important long-term services and supports for eligible people who need ongoing assistance because of age, disability, chronic illness, or functional limitations.
- Skilled nursing facility care
- Personal care services
- Home and Community-Based Services (HCBS)
- Home health services
- Case management
- Respite services under certain programs
- Services that help eligible members remain safely at home or in the community
Some people who qualify for Medi-Cal may also qualify for programs such as In-Home Supportive Services (IHSS).
If you have both Medicare and Medi-Cal, Medicare generally covers many of your primary medical services first. Medi-Cal may provide additional benefits that Medicare does not fully cover, including certain long-term services and supports.
15. Services for Children and Young Adults Under 21
Children and young adults under age 21 with full-scope Medi-Cal receive additional protections through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, also called Medi-Cal for Kids & Teens in California.
- Well-child visits
- Developmental screening
- Dental care
- Vision care
- Hearing services
- Mental health treatment
- Physical, occupational, and speech therapy when medically necessary
- Other medically necessary services allowed under EPSDT
Services That May Require Prior Authorization
Just because a service is a Medi-Cal benefit does not mean every version of that service is automatically approved. Certain surgeries, medications, medical equipment, advanced imaging, specialty therapies, and other services may require prior authorization or proof of medical necessity.
Does My Medi-Cal Health Plan Cover Everything?
Not necessarily. Medi-Cal benefits are delivered through several different systems.
- Medical care: often through your Medi-Cal managed care health plan
- Outpatient prescription drugs: generally through Medi-Cal Rx
- Dental care: through Medi-Cal Dental or a Dental Managed Care Plan, depending on your location and enrollment
- Specialty mental health services: through the county Mental Health Plan
- Substance use disorder services: may be provided through county behavioral health systems
- Some services: may be provided through Fee-for-Service Medi-Cal
Frequently Asked Questions
Does Medi-Cal Cover Doctor Visits?
Yes. Full-scope Medi-Cal covers medically necessary primary care, specialist, clinic, and many outpatient services.
Does Medi-Cal Cover Emergency Room Visits?
Yes. Medi-Cal covers emergency medical services.
Does Medi-Cal Cover Prescription Drugs?
Yes. Most outpatient prescription drug benefits are administered through Medi-Cal Rx.
Does Medi-Cal Cover Dental Care?
Yes, for eligible members. Covered services can include exams, x-rays, cleanings, fillings, extractions, root canals, dentures, and other covered treatment.
Does Medi-Cal Cover Eye Exams and Glasses?
Yes. Medi-Cal covers vision services including eye exams and eyeglasses for eligible members.
Does Medi-Cal Pay for Transportation?
It can. Medi-Cal offers Non-Emergency Medical Transportation and Non-Medical Transportation for eligible members when program requirements are met.
How Do I Find Out if a Service Is Covered?
If you are not sure whether Medi-Cal covers a particular treatment, contact the organization responsible for that benefit.
- Ask your doctor or provider
- Call the Member Services number on your Medi-Cal health plan card
- Contact Medi-Cal Rx for outpatient prescription drug questions
- Contact Medi-Cal Dental for dental questions
- Contact your county Mental Health Plan for specialty mental health services
- Contact DHCS for general Medi-Cal assistance
1-800-541-5555
Official Resources
- DHCS — Medi-Cal Benefits
- DHCS — What Are the Medi-Cal Benefits?
- DHCS — Medi-Cal Rx
- DHCS — Medi-Cal Dental
- DHCS — Vision Care
- DHCS — Medi-Cal Help
California Benefits Guide is an independent informational website and is not affiliated with or endorsed by the State of California, the California Department of Health Care Services (DHCS), Medi-Cal, any county agency, or any Medi-Cal health plan. This article is provided for general educational and informational purposes only and is not medical, legal, or official eligibility advice. Medi-Cal benefits, eligibility, provider networks, authorization requirements, and program rules may change and can vary by individual situation. Always verify current coverage with DHCS, your Medi-Cal health plan, or the appropriate Medi-Cal program.