Medi-Cal & hyperbaric oxygen therapy
Medi-Cal is California's Medicaid program. It covers hyperbaric oxygen therapy for medically necessary indications, but the authorization path is different from Medicare's — and it matters which managed care plan you are enrolled in.
What Medi-Cal covers
Medi-Cal generally follows the same recognized-indication list as Medicare: chronic non-healing wounds, delayed radiation injury, chronic refractory osteomyelitis, compromised grafts and flaps, and the other conditions with established evidence behind them.
The practical difference is authorization. Medi-Cal typically requires a Treatment Authorization Request (TAR) — documentation from your physician establishing medical necessity — approved before treatment begins. This takes time, and starting the paperwork early matters.
Managed care plans in San Diego County
Most Medi-Cal members in San Diego County receive benefits through a managed care plan rather than fee-for-service. Your plan determines the authorization process, the referral requirements, and which facilities are in network. We check which plan you are on as the first step, because it changes everything downstream.
What this means for you
If you have Medi-Cal and a qualifying wound or condition, there is a real path to covered treatment — it simply requires the paperwork to be done properly and in the right order. That is our job, not yours. We prepare the documentation, submit the request, and follow it through.
If your condition is not on the covered list, we will tell you that directly rather than starting a process that will be denied.
Other payers we work with
Aetna
Covers recognized indications per its Clinical Policy Bulletin; requires documentation mirroring NCD 20.29. Off-label uses considered experimental.
Blue Shield
Commercial plans generally follow Medicare's indication list with prior authorization. Off-label uses (e.g. TBI, long COVID) are excluded.
Cigna
Aligns with Medicare's covered indications; prior authorization and periodic reauthorization for extended wound courses.
Medicare
Covers the 14 UHMS-recognized indications under NCD 20.29 (plus diabetic lower-extremity wounds meeting Wagner III+ / 30-day criteria). Part B pays 80% after deductible. Documentation of failed standard care is the usual denial point.
UnitedHealthcare
Covers recognized indications with prior authorization; medical-necessity review common for wound-care courses beyond initial approval.