Medi-Cal Coverage, Explained.

For Medi-Cal members anywhere in Partnership HealthPlan's 24-county Northern California service area.

Partnership HealthPlan of California is the nonprofit Medi-Cal managed care plan serving a 24-county region across Northern California, from Del Norte and Siskiyou in the far north down through Marin and Solano in the North Bay. If your Medi-Cal is administered through PHP, outpatient mental health therapy is a benefit you already have. This guide covers what is actually covered, who qualifies, how to start, and links to a dedicated page for every county PHP serves.

Covered services include individual therapy, group therapy when clinically appropriate, crisis intervention, and psychiatric medication management, all delivered by contracted clinicians. There is no hard annual cap on sessions when care is medically necessary, and your plan cannot require a copay for Medi-Cal-covered services. “Medically necessary” is a clinical determination your therapist makes during your first session, not a pre-approval hurdle you have to clear before treatment starts.

You do not need a referral, a member card, or a prior authorization to start.

You do not need a referral from a primary care provider, and there is no separate application or approval process. You can contact a PHP-contracted provider directly. PMHS is a contracted PHP provider, which means your sessions are billed to PHP directly and you typically owe nothing out of pocket for covered care.

For members under 21, coverage is often broader than the standard adult outpatient benefit. This runs through EPSDT, a federal mandate built into Medi-Cal that guarantees comprehensive screening and treatment coverage for children and teens. A parent or guardian can start the process on a minor's behalf.

Telehealth is not a lesser version of this benefit. California law requires Medi-Cal managed care plans, including PHP, to cover telehealth at parity with in-person care. Your plan cannot impose extra barriers on telehealth that do not apply to an in-person visit, and distance from a physical office cannot be used to deny you access to a covered benefit.

If you are not sure whether your Medi-Cal is administered through PHP, check the managed care plan name printed on your benefits card, or log into your BenefitsCal account. If it says Partnership HealthPlan or PHP, everything above applies to you.

Find Your County

Every county below has its own dedicated page with local resources, hospitals, crisis lines, and coverage details specific to that community.

Getting started takes a few minutes. Submit our intake form at www.pacmhs.com/connect and we will reach out within one hour between 8am and 8pm, or by 9am the next morning, to verify your PHP coverage and get your first session scheduled.