Orange County - Care1st Health Plan

Getting care when traveling or away from the plan’s service area
If you need care when you are outside the service area, your health care coverage is very limited.
The only services we cover when you are outside our service area are care for a medical
emergency, including maintenance care and hospital care after you are stable (known as poststabilization
care), urgently needed care, renal dialysis (kidney), and care that Care1st Health
Plan or a plan provider has approved in advance.
Emergency care can always be obtained in or out of the service area from the nearest available
provider. When in the service area you must use plan providers for urgent care. When out of the
service area urgent care may be obtained from the first available provider. In addition, when out
of the service area you can obtain dialysis treatment from any qualified dialysis provider. If you
obtain routine care from out-of-network providers neither Medicare nor Care1st Health Plan will
be responsible for the costs.
If you question whether a service is covered when you travel, please call our Member Services
Department at 1-800-544-0088 (TTY 1-800-735-2929) from 8:00 a.m. to 8:00 p.m., seven days a
week.
What is the service area for Care1st Health Plan?
The county in our service area is listed below.
Orange County, the following zip codes only:
90620, 90621, 90622, 90623, 90624, 90630, 90631, 90632, 90633, 90638, 90680, 90720, 90740,
90742, 90743, 92609, 92610, 92617, 92619, 92620, 92626, 92637, 92646, 92647, 92648, 92649,
92655, 92657, 92673, 92683, 92685, 92694, 92697, 92698, 92701, 92702, 92703, 92704, 92705,
92706, 92707, 92708, 92725, 92735, 92801, 92802, 92803, 92804, 92805, 92806, 92807, 92808,
92809, 92812, 92814, 92815, 92816, 92817, 92821, 92822, 92823, 92825, 92831, 92832, 92833,
92834, 92835, 92836, 92837, 92838, 92840, 92841, 92842, 92843, 92844, 92845, 92846, 92850,
92868, 92870, 92871, 92885, 92886, 92887, 92899
How do you find Care1st Health Plan providers in your area?
If you are a new enrollee in Care1st Health Plan, follow these steps to choose your Primary
Care Physician:
1. Use the index of Primary Care Physicians located in the back of the Directory for the
doctor you want. The index is in alphabetical order by the doctors’ last names. Write
down the page number(s) listed after his or her name (these page numbers indicate their
associated Medical Group/IPA).
2. Review the participating Medical Group/IPAs and their Participating Primary Care
Physicians.
3. Select the Primary Care Physician you want.
4. Enter the “Provider ID” number found under the Primary Care Physician’s name on the
Care1st Health Plan enrollment form.
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