Member Handbook - Los Angeles County Department of Health ...

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Medi-Cal Member Handbook / Benefit Year 2006-2007WELCOME: Now that you arewith L.A. Care Health Plan!Thank you for choosing L.A. Care Health Plan.L.A. Care is a government agency created tenyears ago to help Los Angeles County Medi-Calmembers get quality health care. L.A. Care is alsocalled the Local Initiative Health Authority forLos Angeles County. But you can call us“L.A. Care.”With the help of the health plans we work with,L.A Care serves nearly 800,000 members in LosAngeles County. We only serve people who livein Los Angeles County (called our “servicearea”). L.A. Care Health Plan is the largest publichealth plan in the nation. We are growing becausewe are a trusted source for health care and werespect our members.L.A. Care is a pre-paid health coverage program,called a “health maintenance organization” orHMO. The State of California has givenL.A. Care permission to serve you. The State ofCalifornia pays for your health care. There is nocost to you when you get services covered byMedi-Cal.Your Health Plan Choices with L.A. CareL.A. Care works with five other health plans toprovide health care services for members. L.A.Care and these health plans are licensed with theState of California. L.A. Care and our health planpartners have contracts with many doctors,hospitals, pharmacies and other health careproviders to serve you.When a Medi-Cal member joins L.A. Care, themember can choose to receive services throughone of five health plans:• Blue Cross of California• Care1st Health Plan• Community Health Plan• Kaiser Permanente• UHP HealthcareWhen you picked L.A. Care for your Medi-Cal,you also picked Community Health Plan as yourhealth plan. (If you didn’t pick a health plan, wepicked one for you.) Community Health Plan isresponsible for almost all of your health careservices. Some benefits like dental and vision arenot provided by your health plan. This is talkedabout in the section “More benefits: What otherservices can I get?” in this handbook.How to Change Health PlansWe believe you will like Community Health Plan.But you can change your health plan for anyreason. Call L.A. Care at 1-888-4LA-CARE (1-888-452-2273) to change your health plan. Ifyou call L.A. Care before the 20 th of the month,the change will be effective on the 1 st of the nextmonth. If you call L.A. Care on or after the 20 thof the month, the change will start on the 1 st ofthe month following the next month. When youchange health plans, you will get an ID card fromyour new health plan. Be sure to tear-up your oldhealth plan ID card.Some plans do not serve all of Los AngelesCounty. Call the health plan to ask about theirservice area and to make sure it can serve youbefore you change. You cannot get routine carelike check ups outside of your health plan’sservice area. But don’t worry: No matter whichhealth plan you choose, you can get urgent oremergency care anywhere when you need it –even outside of Los Angeles County.3Community Health Plan Member Services Department toll-free 1-800-475-5550L.A. Care Health Plan Member Services Department toll-free 1-888-4LA-Care or 1-888-452-2273
Medi-Cal Member Handbook / Benefit Year 2006-2007ID Cards: How do I use them?What to do with your L.A. Care/CommunityHealth Plan ID cardAlong with this handbook you received an L.A.Care/Community Health Plan ID card for everyfamily member covered by Medi-Cal. If you didnot receive an ID card for a family member whois covered by Medi-Cal, call Community HealthPlan right away.Your L.A. Care/Community Health Plan ID cardhas important information on it, including:• Your PCP doctor’s name (or the name of yourclinic or medical group)• Your PCP doctor’s phone numberHere’s what to do with your ID card:What to do with your Medi-Cal card(also known as BIC card)The State of California sent you another ID card,your Medi-Cal Benefits Identification Card (alsocalled a BIC card). You need to show your Medi-Cal card whenever you get services you don’t getfrom L.A. Care/Community Health Plan. Theseservices are talked about in the section, “ Morebenefits: What other services can I get?” in thishandbook. Call the California Department ofPublic Social Services (DPSS), toll-free at 1-877-481-1044 if you need a new Medi-Cal card.Never let anyone use your health plan ID cardor Medi-Cal card. This is called fraud. Youcan lose your Medi-Cal benefits if someone elseuses your ID cards to get care. If you lose yourMedi-Cal benefits, L.A. Care/CommunityHealth Plan will not be able to give you care.• Check to make sure the information on yourID card is correct. Is your name spelled right?Is your birth date right? If anything on yourID card is wrong, call Community Health Planat 1-800-475-5550 right away. CommunityHealth Plan will connect you to the CaliforniaDepartment of Public Social Services (DPSS),toll-free at 1-877-481-1044, to get it fixed.• Keep your ID card in a safe place. If you loseor damage your ID card, call CommunityHealth Plan at 1-800-475-5550.• Show your ID card whenever you:ooooHave a doctor’s appointmentGo to the hospitalNeed emergency servicesPick up a prescription4Community Health Plan Member Services Department toll-free 1-800-475-5550L.A. Care Health Plan Member Services Department toll-free 1-888-4LA-Care or 1-888-452-2273
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