Title 22 CCR §53851(a) states: "Each plan in a designated region shall provide or arrange for the provision of all Medi-Cal covered services to be delivered, unless excluded under the contract, in accordance with the terms and conditions of the contract between the plan and the department."

In California, mental health services are excluded under managed care plan contracts with two exceptions. Mental health services are plan-covered benefits under the Solano Partnership Health Plan (the county operated health system for Solano County) and under Kaiser Permanente in Sacramento County.

When mental health services are excluded from a managed care plan contract, there is no basis to grant a medical exemption from enrollment to a mandatory enrollee if the exemption request is based on a mental health condition such as depression or anxiety disorder. The mandatory enrollee may obtain mental health services either on a fee-for-service basis or through a county mental health plan.