Medi-Cal Rx Transition
New process for Medi-Cal drug benefits
Starting on January 1, 2022, your drug benefits will be handled differently
Starting January 1, 2022, HPSM will no longer manage your drug benefits. The State of California, through the Department of Health Care Services (DHCS), has changed how drug benefits for Medi-Cal members will be handled. The new drug benefit will be called “Medi-Cal Rx”. DHCS has made this change in order to place all Medi-Cal drug benefits under one statewide delivery system. A new contractor, Magellan Medicaid Administration, Inc. (Magellan) will work with DHCS to provide coverage for your drug benefits. This change will also apply to pharmacy services for California Children’s Services (CCS) program.
You do not need to do anything. This change will be automatic. DHCS will start working with Magellan on January 1, 2022. Your Medi-Cal eligibility and benefits will stay the same. Your Medi-Cal eligibility and other benefits managed by HPSM will not change. The only change will be to how your drug benefits are handled.
How to get ready for this change
Read the materials from DHCS
DHCS sent two notices to you already. These notices explain the new drug benefit management program and describe the new procedures.
For most people, nothing will change. In some instances, your doctor may have to fill out a form to get approval when you renew or change your prescriptions.
If you have more questions about this change after reading all materials, you can call 1-800-977-2273. (TTY users: dial 7-1-1.) Or visit DHCS's Medi-Cal Rx website.
Click on the buttons below to learn more about how you can prepare for this change. More information can also be found on the Medi-Cal Rx website.
CareAdvantage, HealthWorx and ACE members will not be affected by this change
HPSM will continue to manage CareAdvantage, Healthworx and ACE members’ drug benefits