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Substance Use

Drug Medi-Cal and My Health LA Benefits and Program Eligibility

Benefits:

Drug Medi-Cal (DMC) and My Health LA (MHLA) provide access to identical benefits which include:

  • Withdrawal management
  • Medication Assisted Treatment
  • Residential Treatment
  • Case Management
  • Outpatient Treatment
  • Recovery Support

Tarzana Treatment Centers, (TTC) offers each of these services to patients who meet eligibility criteria.

Eligibility:

MHLA participants must meet the following criteria:

  • Uninsured and lack access to a full-scope health program
  • Must not be eligible for publicly-supported health insurance (like Medi-Cal or Covered CA)
  • A Los Angeles County resident
  • Be at least 19 year’s old
  • Household income at/below 138% of the Federal Poverty Level
  • Must meet medical necessity criteria, see below

DMC eligibility verification requirements for patients:

  • Resides within Los Angeles County.
  • Must be enrolled in Medi-Cal.
  • Must meet medical necessity criteria, see immediately below, for adults or adolescents

Medical necessity criteria include:

  • Meeting the diagnostic criteria for a Substance Use Disorder (SUD), and
  • Meeting the criteria for a specific benefit. The criteria for admission to withdrawal management, residential or outpatient treatment are defined by the nationally recognized criteria.

Prior to admission, potential patients are assessed by members of the clinical team to determine the appropriate level of care (withdrawal management, residential, or outpatient) for each person. Some individuals may require Withdrawal Management (Detox), while others may be appropriate for Residential or Outpatient levels of care. DMC regulations require that admission criteria be met and that for residential treatment TTC seek approval from LA County Department of Substance Abuse Prevention and Control at the time of admission. Once admitted to any level of care, patients must meet continued stay criteria to remain at the current level of care or to be “stepped down” to a lower level of care.