An Advocate’s Guide to Medi-Cal Services

Executive Summary

NHeLP’s Medi-Cal Services Guide provides an in-depth description of some of the most important services covered in the Medi-Cal program, including prescription drug services, mental health and substance use disorder services, reproductive and sexual health services, gender-affirming services, among others. The guide seeks to help legal aid attorneys, health advocates, and other stakeholders across California understand the Medi-Cal program and defend the health rights of low-income individuals in the State.

Relevant chapters updated in 2025 and 2026 now emphasize policy changes implemented pursuant to the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including new chapters on Care Coordination and Community Supports. In addition, some chapters have been updated to reflect the changing landscape of behavioral treatment, by incorporating a description of the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) program.

The individual chapters can be downloaded below.

An Advocate’s Guide to Medi-Cal Services 2025-2026 (entire guide, all chapters and indexes)

Foreword and Table of Contents 

1. Overview of Medicaid and Medi-Cal

2. Preventive Services

3.  Prescription Drugs

4. Mental Health Services 

5.  Substance Use Disorder Services

6. Gender-Affirming Services

7. Reproductive and Sexual Health Services

8. Dental Services 

9.  Children’s Health Services

10.  Long-Term Services and Supports

11. Durable Medical Equipment, Orthotics and Prosthetics, and Other Non-Pharmaceutical Items

12. Care Coordination: Case Management and Community Health Worker Services

13. Community Supports

14. Ancillary Services

Appendix A: Commonly Referenced Laws and Commonly Used Terms

Appendix B: Medi-Cal Resource List

Through policy advocacy and litigation, the National Health Law Program protects and advances access to Medi-Cal coverage and services, and the rights of individuals eligible for the program. We have extensive expertise in federal and state Medi-Cal laws, regulations, and policies and share the expertise through training and assistance to California health advocates, legal services programs, private attorneys, and other stakeholders.

 

Related Content