Objective. To assess differences in perceived quality of care between fee-for-service (FFS) and managed care Medicaid (MMC) by seniors and persons with disabilities (SPD) and to generate hypotheses for future evaluations of the new managed care mandate for SPD in California. Methods. A cross-sectional telephone survey of 403 SPD Medicaid beneficiaries comparing perceived access to, satisfaction with, and quality of care between beneficiaries who had voluntarily enrolled in MMC with those who had remained in FFS. Results. Beneficiaries in MMC were more likely to be "very satisfied" with their benefits than those in FFS. There was no significant difference on any measure of access to care. Most beneficiaries in MMC reported their access to and quality of health care was either the same or better than it had been in FFS. Conclusion. On most measures, MMC was rated either the same or better than FFS by SPD beneficiaries who voluntarily enrolled in MMC.