Frequently Asked Questions
Find answers to your health insurance questions below. If your questions are not answered on this page, please call Member Services for help.
Medi-Cal is California's Medicaid health care program. It provides no-cost or low-cost essential medical coverage. To get Medi-Cal, you must meet certain eligibility requirements.
Medi-Cal benefits include:
- Outpatient (ambulatory) services.
- Emergency services.
- Hospitalization.
- Maternity and newborn care.
- Mental health and substance use disorder (SUD) services, including behavioral health treatment.
- Prescription drugs.
- Programs such as physical and occupational therapy (known as rehabilitative and habilitative services) and devices.
- Laboratory services.
- Preventative and wellness services and chronic disease management.
- Children's (pediatric) services, including oral and vision care.
- Dental and Vision.
- In-Home Support Services.
Most people who have Medi-Cal get benefits and services through a managed care health plan. Some programs may also be offered through Medi-Cal Fee-for-Service.
Central California Alliance for Health (the Alliance) is a managed care plan for people who have Medi-Cal. The Alliance works with the State of California to provide health care coverage to people who live in Merced, Monterey and Santa Cruz counties. We help members get started with their health insurance plan, answer questions about their health care and learn how to be healthy. We care about our members!
Member Services Representatives are available to answer health plan questions. The Alliance offers:
- Help with finding doctors and specialists.
- A Nurse Advice Line you can call 24/7 at no cost.
- Interpreter services if you do not speak English.
- Transportation to medical appointments.
For information on all benefits and services, please see the Medi-Cal Member Handbook.
Medi-Cal is available for those who meet income level requirements. To find out more information about Medi-Cal or to see if you qualify for this health insurance, contact your county's office:
- Merced County
Human Services Agency
209-385-3000
855-421-6770 - Monterey County
Department of Social Services
877-410-8823 - Santa Cruz County
Human Services Department
888-421-8080
For the Hearing or Speech Assistance Line, call 800-735-2929 (TTY: Dial 711).
You should have received your BIC when you first became a Medi-Cal member. If you did not receive your BIC or it is lost or stolen, you may ask for a replacement BIC for free. Please contact your local county Medi-Cal office.
- Merced County
Human Services Agency
209-385-3000
855-421-6770 - Monterey County
Department of Social Services
877-410-8823 - Santa Cruz County
Human Services Department
888-421-8080
The Alliance can provide you with a new Alliance Member ID card. You can order a new card online by filling out the order form or by calling Member Services at the Alliance.
Your private insurance, also referred to as other health coverage (OHC), is your primary health insurance. The Alliance is your secondary insurance. When you go to the doctor, show them both your private insurance card and your Alliance Member ID card.
Call Member Services at the Alliance to report this change. You can also report this change through the DHCS website.
Medicare is the health plan for people 65 years or older. People who are not able to work because of a disability may also get Medicare. When you go to the doctor, show them both your Alliance Member ID card and your Medicare card.
There are three parts to Medicare:
- Medicare Part A covers stays in the hospital.
- Medicare Part B pays for doctor visits, durable medical equipment (DME), lab work and x-rays.
- Medicare Part D pays for prescription medicines.
If you have Medicare Parts A, B & D and Medi-Cal:
Medicare will always be your primary health insurance |
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Medi-Cal will always be your secondary health insurance |
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Your medicine will be covered by your Medicare drug plan. You will have to pay a small co-pay for each prescription.
The Alliance will cover a small number of medicines that are not covered by Medicare.
Yes, you can change your doctor by calling Member Services at the Alliance.
You can also visit our Find a Doctor page to select a new doctor online.
After choosing a new doctor, the soonest you can see them for an appointment is the first day of the following month. For example, if you change your doctor on August 10, you can see your new doctor on September 1.
If the doctor you want for your child is taking new members, your child can be assigned to that doctor. Call Member Services at the Alliance to see if this is possible.
You can file a grievance (complaint) at any time by phone, in writing or online.
- By phone: Call the Alliance at 800-700-3874 (TTY 800-735-2929 or 711) between 8 a.m. and 5:30 p.m.
- By mail: Call the Alliance at 800-700-3874 (TTY 800-735-2929 or 711) and ask to have a form sent to you. When you get the form, fill it out. Be sure to include your name, Alliance Member ID number and the reason for your complaint. Tell us what happened and how we can help you.
Mail the form to:
Grievance Department
1600 Green Hills Road, Suite 101,
Scotts Valley, CA 95066
Your doctor’s office will have complaint forms available.
- Online: Go to File a Grievance.
If you need help filing your complaint, we can help you. If you speak another language other than English, language assistance services are available to you at no cost. Call Member Services at 800-700-3874 (TTY 800-735-2929 or 711).
You will need to contact both the Alliance and your county’s Medi-Cal office if you move or change your phone number. To inform the Alliance, use the Update Personal Information form or call Member Services at the Alliance. Use the numbers below to contact your county’s Medi-Cal Office:
Merced County 209-385-3000 |
Monterey County 877-410-8823 |
Santa Cruz County 888-421-8080 |
If you got a bill for a covered service, please call Member Services at the Alliance right away.
The Alliance can provide you a way to get to and from an appointment for a covered Medi-Cal service or benefit.
You can find more information on our Transportation Services page.
Medi-Cal covers some dental services. If you have questions or want to learn more about dental services, call the Medi-Cal Dental Program at 800-322-6384 (TTY: Dial 711). You may also visit the Medi-Cal Dental website.
You can get a routine eye exam once every two years. Coverage includes eyeglasses (frames and lens) once every two years or contact lenses for certain medical conditions. No referral is needed to access routine vision care services.
To learn more about your vision benefits or to find a provider near you, call Vision Service Plan (VSP) at 800-877-7195.
The Alliance works with Carelon Behavioral Health (Carelon) to provide mental health and behavioral health services. You can call Carelon directly at 855-765-9700 (TTY: Dial 711). Carelon will be able to assist you 24 hours a day, 7 days a week. They will help you find a mental health provider that meets your needs, such as language spoken, location or specialty area.
Some specialty mental health services (SMHS) are provided by county mental health plans instead of the Alliance. If the Alliance decides that you will need services from the county mental health plan, the Alliance will help connect you to those services.
Medi-Cal Rx: Frequently asked questions (FAQ) for your Medi-Cal prescription drug benefit
Your prescriptions that are filled at a pharmacy are covered by Medi-Cal Rx. Medi-Cal Rx is a program provided by the California Department of Health Care Services (DHCS) to help you with your pharmacy needs.
You will need to show your Medi-Cal Benefits Identification Card (BIC) when filling a prescription at the pharmacy.