Alliance Alternative Access Standards
Alliance Alternative Access Standards are set by the Department of Health Care Services (DHCS) and provide health plans with guidelines on time and distance standards for members to access health care services.
The Department of Health Care Services (DHCS) provides health plans with guidelines on time and distance standards for members to access health care services. These standards make sure that providers of certain health care services are located within a certain number of miles or travel time from where members live or are available by telehealth when accessing approved services. All health plans must meet these standards or have an established Alternative Access Standard (AAS) approved by DHCS.
Time and distance standards for primary care providers (PCP), specialists and hospitals:
|Provider Type||Time and Distance Standard|
(adult and pediatric)
|10 miles or 30 minutes from the member’s residence|
(adult and pediatric)
|Based on county population density
Santa Cruz County
Merced and Monterey Counties
|Hospital||15 miles or 30 minutes from the member’s residence|
|Telehealth||When approved by DHCS.|
The list below shows the time and distance standards by zip code and the provider types that are approved by DHCS. If you need to get care from a provider that is located far away from where you live, you can call Member Services for help. They will work with you to find a provider that is close to where you live. You can also request transportation services if the Alliance cannot find care near you, even if that provider is located far away. Far away means you cannot get to that provider within the Alliance’s travel time and distance standards for your county, regardless of any Alternative Access Standard the Alliance may use for your zip code. The Alliance can also arrange care for you with a provider who is closer to you but is not part of the Alliance provider network. Or, you might get care from a telehealth provider for allowed services.
Call Member Services at 800-700-3874 (TTY: Dial 711). Monday through Friday, 8a.m.–5:30 p.m.
If you speak another language other than English, language assistance services are available to you at no cost.
Welfare and Institutions Code section 14197.04(c)
Revised Final Network Adequacy Standards (March 26, 2018)
Policy # 300-7030-Reimbursement Non-Contracted Providers
Policy # 200-2010 Non-Medical Transportation
Member Handbook Evidence of Coverage (EOC) and Disclosure Form