
Insurance, Payment Options & Forms
At Planned Parenthood, we have many different options when it comes to paying for care. Here, you can find information on types of insurance we accept, payment options, and our sliding scale.
The bottom line: No one will be turned away from receiving care.
Medi-Cal Renewal Notice
Medi-Cal insurance coverage needs to be renewed each year. Be sure to update your contact information at KeepMediCalCoverage.org.
Medical Forms
Family PACT
This program helps cover your reproductive care services if you don't have insurance.
Download Family PACT form:
English | Spanish
Medical Records Release Form
To request your medical records be sent to Planned Parenthood or mailed to you by Planned Parenthood please fill out a HIPAA release form.
Download medical records release form:
English | Spanish | Vietnamese
CalOptima: COVID-19 Vaccine Member Health Reward
Eligible CalOptima members 5 years of age or older can receive up to two $25 gift cards for a two-dose vaccine or one $25 gift card for a single-dose vaccine. Gift cards will be mailed after CalOptima confirms through the California Immunization Registry that you received your COVID-19 vaccine. No forms required. Members must be eligible on the date of service. Members in long-term care, PACE or enrolled in Kaiser are not eligible. If you received your COVID-19 vaccine, please be patient as there may be delays in confirming your vaccination and mailing your gift card(s) for the COVID-19 Vaccine Member Health Rewards program. If you received a vaccine that requires 2 doses, you may receive your gift card for the 1st and 2nd doses at different times.
Need a Ride?
If you have Medi-Cal insurance, you can get free transportation to your Medi-Cal covered appointment. View form for more information.
*Please note that this is being offered by the health plans, so Planned Parenthood is unable to arrange the transportation or answer questions about the service.
Open Payments Database Notice
The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov. For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
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Book an Appointment
Or call 1-800-230-7526