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Primary Care

Primary care, also called routine care or regular health care, includes preventative care to help you stay healthy and get medical help when you are sick. As an Alliance member, you can get primary care by visiting a doctor who is part of our health plan. The Alliance will pay your health care bills.

You can begin receiving health care services as soon as your coverage starts. The effective date of your coverage is shown on your Alliance ID card that was mailed to you. Remember to always carry your Alliance ID card, Medi-Cal Benefits Identification Card (BIC) and any other health insurance cards with you whenever you get health care services. Never let anyone else use your Alliance ID card or BIC card.

If you are new to the Alliance, you will need to find a doctor. We can help you find the right doctor to see near you. If your current doctor is not in the Alliance network, there are some cases that you can still keep seeing them for up to 12 months.

Ready to choose or change your primary care doctor?

Use the Provider Directory to find a doctor near you who is accepting new patients. After you find a doctor, complete the Choose Primary Doctor form online or call Member Services for help.

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What kinds of services are included in primary care?

The types of services you get with routine care include:

Check-ups.
Shots.
Treatments.
Prescriptions.
Tests and screenings.
Health education and counseling.

Who do I go see for primary care?

You will get all of your routine care from your primary care provider (PCP). Your PCP will:

Get to know your health history and needs.
Keep your health records.
Give you the preventive and routine care you need.
Refer (send) you to a specialist if you need one.
Arrange for hospital care if you need it.

When and how do I use primary care?

You can get primary care as soon as your coverage starts. As a new Alliance member, you should see your new PCP for an initial health assessment within 120 days of becoming an Alliance member so they can learn about you and your health.

Remember to do the following when you call to schedule your new patient exam:

Tell the person who answers the phone that you are a member of the Alliance.
Give your Alliance ID number.
Take your Alliance ID card, BIC and any other health insurance cards to your appointment.

Be ready to talk with your PCP about your health care needs and concerns. It is a good idea to take a list of your medications and questions with you to your visit.

Preparing for your appointment

Practicing good communication with your doctor is important to ensuring that your health care needs are met. Clear and honest communication between you and your PCP can help you feel safe to voice your concerns and make informed choices.

We know that talking with your PCP is not always easy but open communication will lead to increased satisfaction with your doctor. Below are some examples of topics to discuss with your PCP if you have health concerns during your visit.

Question	Example
What am I seeing or feeling that I want my primary care provider to check?	My left ear aches each time I blow my nose.
When did it begin?	It started about a week ago when I first caught a cold.
What makes it better or worse?	It feels worse when I blow my nose and feels better in the morning after I shower.
What questions do I have and what worries me?	When will I start to feel better? Does the medicine have side effects?

Other tips for your visit to the doctor:

Bring a list of all the medications you are taking.
If you have any medical needs, such as wheelchair access, or require language assistance or interpreting services, let the doctor’s office staff know so they can help you.
Ask what the office policy is for missed appointments. The office can help to reschedule appointments or provide other options, such as phone appointments, if it is difficult to go to the doctor in person.
If you do not have transportation to your appointment, the Alliance can help with transportation services. Contact Member Services at 800-700-3874 (TTY: Dial 800-735-2929 or 711) for more information.

Regular routine care

After your new patient exam, you can continue to get routine care from your PCP. When you need routine care, call your PCP to schedule an appointment.

It is important to know that routine care is not urgent care or emergency care.

Urgent care is care you need to prevent serious damage to your health from a sudden illness, injury or complication of a condition you already have.

For urgent care concerns, call your PCP.
If you cannot reach your PCP, call Member Services at 800-700-3874 (TTY: Dial 800-735-2929 or 711).
You can also call the 24/7 Nurse Advice Line at 844-971-8907 (TTY: Dial 711).

Emergency care is for life-threatening medical conditions.

For an emergency, call 911 or go to the nearest emergency room.
If you are not sure if your medical condition is an emergency, call your PCP.
You may also call the 24/7 Nurse Advice Line at 844-971-8907 (TTY: Dial 711).

Examples of emergency care may include, but are not limited to:

Active labor.
Broken bone.
Severe pain.
Chest pain.
Severe burn.
Drug overdose.
Fainting.
Severe bleeding.
Psychiatric emergency conditions, such as severe depression or suicidal thoughts.

Do not go to the ER for routine care. You should get routine care from your PCP, who knows you best.

How do I choose my PCP?

As a new Alliance member, you can choose your PCP from a list of providers in the Alliance network. If you do not choose a PCP within 30 days, the Alliance will choose one for you.

View detailed instructions on how to choose your PCP. You must confirm your choice with the Alliance.
View the Provider Directory.

How do I change my PCP?

To change your PCP, use the online form or call Member Services at 800-700-3874 (TTY: Dial 711). They are open from 8 a.m. to 5:30 p.m., Monday through Friday. Changes will start the first day of the next month.