Member Resources
Member Handbook
This document explains your rights, responsibilities and benefits as a Member of CalViva Health.
> Download the Member Handbook (English)
> Download the Member Handbook (Español)
> Download the Member Handbook (Hmong)
| Referrals and Pre-approval Pre-approval (prior authorization) For some services, your PCP or specialist will need to ask CalViva Health for permission before you get the care. CalViva Health makes sure the care is medically necessary. This is called asking for pre-approval or prior authorization. Your PCP or specialist will work with CalViva Health to get the pre-approval (prior authorization). Getting a pre-approval may take 5 days or up to an additional 14 days if we need more information from your PCP. If urgent, it will take no more than 72 hours. Referral If you need a specialist for your care, your PCP or another specialist will give you a referral to one. A specialist is a provider who focuses on one type of health care service. The doctor who refers you will work with you to choose a specialist and let you know if you need pre-approval (prior authorization) or whether you can make the appointment directly. Please refer to your CalViva Health Member Handbook for a complete list of services that require a referral or a pre-authorization. The information can be found under Section 3- How to get Care: Referrals and Pre-Approval (prior authorization). |
Download the CalViva Health Member Rights and Responsibilities
Medi-Cal for Kids and Teens
Under California and federal law, all children and youth to age 21 enrolled in Medi-Cal have the right to regular check-ups and other preventive and treatment services needed to stay or get healthy.
> Download the Medi-Cal for Kids & Teens: Your Medi-Cal Rights Letter (English)
Download the Medi-Cal for Kids & Teens: Your Medi-Cal Rights Letter (Spanish)
Download the Medi-Cal for Kids & Teens: Your Medi-Cal Rights Letter (Hmong)
> Download the Medi-Cal for Kids & Teens: Teen Brochure (English)
Download the Medi-Cal for Kids & Teens: Teen Brochure (Spanish)
Download the Medi-Cal for Kids & Teens: Teen Brochure (Hmong)
> Download the Medi-Cal for Kids & Teens: Child Brochure (English)
Download the Medi-Cal for Kids & Teens: Child Brochure (Spanish)
Download the Medi-Cal for Kids & Teens: Child Brochure (Hmong)
Continuity of Care Policy
Learn how to continue your care if the status of your health plan changes.
Download the Continuity of Care Policy (English)
Download the Continuity of Care Policy (Español)
Download the Continuity of Care Policy (Hmong)
Please note: There are new options for managing your Digital Medical Records.
Contract Drug List
View the Contract Drug List (CDL) on the DHCS website
The California Department of Health Care Services (DHCS) maintains the Medi-Cal CDL.
Member Transportation Services Guide
Learn how to receive no-cost transportation services.
> Download the Member Transportation Services Guide (English)
Download the Member Transportation Services Guide (Español)
Download the Member Transportation Services Guide (Hmong)
Disaster Assistance Guide for Immigrant Californians
This guide provides information about the types of federal, state, and local
disaster assistance services available in California.
Disaster Assistance Guide for Immigrant Californians (English)
Where to Find Same-Day Health Care
Learn where to get care when you need it fast. This guide can help you make the right choice when you need same-day health care services.
Population Needs Assessment
The CalViva Health Population Needs Assessment (PNA) report aims to identify the needs of its Medi-Cal members, review available programs and resources, and identify gaps in services. CalViva Health’s PNA development process was designed to meaningfully gather and synthesize data from primary data sources to inform the development of action plans to improve member health outcomes and experiences.