This document explains your rights, responsibilities and benefits as a Member of CalViva Health.
|Referrals and Authorizations
For some services, your PCP or specialist will need to get pre-approval, or an OK, from CalViva Health before you get them. These are also called prior authorizations. Your PCP will work with CalViva Health to get the pre-approval. 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.
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). You can download the Member Handbook (English) here.
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)
Continuity of Care Policy
Learn how to continue your care if the status of your health plan changes.
Please note: There are new options for managing your Digital Medical Records.
Contract Drug List
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.
Disaster Assistance Guide for Immigrant Californians
This guide provides information about the types of federal, state, and local
disaster assistance services available in California.
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.