Molina Healthcare of California (MHC) works closely with the
Department of Health Care Services (DHCS) and external vendors to ensure that
Medi-Cal members receive the full breadth of whole-person readily available
care.
Effective July 1, 2024, MHC is contracted with VSP
Vision Care for optometry and optical services. MHC providers may refer members
to participating optometrists and ophthalmologists through the VSP Find an Eye Doctor tool.
Primary Care Practitioners (PCPs) are the primary screeners
for ocular abnormalities requiring referral for a comprehensive eye
examination. Comprehensive eye examinations performed by an optometrist or
ophthalmologist are covered for all Medi-Cal members.
Dental services, other than dental screenings, are not
covered by MHC. These services are carved out to the Medi-Cal Dental Program (formerly called
Denti-Cal).
Dental referrals do not require prior authorization. Providers
may refer members to the dental providers listed on the Medi-Cal
Provider Directory. If there are no local accepting providers available,
please contact the Medi-Cal Telephone Service Center line at (800) 322-6384.
MHC members are entitled to an annual dental screening
performed by their PCP at each health assessment. The dental screen's findings,
including education provided to the member or family, should be documented in
the member’s medical record.
Medi-Cal Rx
administers pharmacy benefits to Medi-Cal members. Providers are encouraged to
utilize the Medi-Cal Rx Find a Pharmacy Tool and Provider
Portal to conduct pharmacy services.
Medi-Cal Rx covers all medically necessary Medicaid
medications. Providers may prescribe drugs from the Medi-Cal Rx Contract
Drug List or request prior authorization for MHC members to obtain the drug
at a pharmacy.