Frequently Asked Questions
Frequently Asked Questions, Answered
Medi-Cal is California's Medicaid health care program that provides no-cost or low-cost health insurance to Californians. Medi-Cal is a health care program that helps you manage your care or your child's care. Benefits include:
- Help with finding doctors and specialists.
- A Nurse Advice Line you can call 24/7 at no cost.
- Member Service Representatives available to answer health plan questions.
- Offer interpreter services if you do not speak English.
- Transportation to medical appointments.
- Access to dental, vision and behavioral health services.
- Prescription drug coverage.
- In-Home Support Services.
Central California Alliance for Health (the Alliance) is a health 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, find a doctor, answer questions about their health care and learn how to be healthy. We care about our members!
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:
- SANTA CRUZ COUNTY
Human Services Department
- MONTEREY COUNTY
Department of Social Services
- MERCED COUNTY
Human Services Agency
For the Hearing or Speech Assistance Line, call 800-735-2929 (TTY: Dial 711).
Your private insurance is your primary health insurance and the health insurance from the Alliance is your secondary health insurance. When you go to the doctor, show them both your private health insurance card and your Alliance Member ID card.
Call Member Services at the Alliance.
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 pays for stays in the hospital.
- Medicare Part B pays for doctor visits, 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||And your Medi-Cal will always be your secondary health insurance|
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 PCP by calling Member Services at the Alliance.
You can also visit our website to select a new PCP.
After choosing a new provider, the soonest you can see your PCP for an appointment is the first day of the following month. For example, if you change your PCP on August 10, you can see your new PCP on September 1.
If the provider you want for your child is taking new members, your child can be assigned to that provider. 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 877-548-0857 or 711) between 8 a.m. and 5:30 p.m.
- By mail: Call the Alliance at 800-700-3874 (TTY 877-548-0857 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:
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 877-548-0857 or 711).
The Alliance can provide you with a new Alliance Member ID card. You can order a new card online by filling out the Replace ID Card form or call Member Services at the Alliance.
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-Call Office:
Santa Cruz County
Please call Member Services at the Alliance.
The Alliance can provide you a way to get to and from an appointment for a covered Medi-Cal service or benefit. This service is called non-medical transportation (NMT).
To request NMT services, please call Member Services at 800-700-3874 (TTY 877-548-0857 or 711) least five to seven business days (Monday-Friday) before your appointment. If you have an urgent appointment, call us as soon as you can. Please have your Alliance member ID card ready when you call.
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 lens 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 Beacon Health Options (Beacon) to provide mental health and behavioral health services. You can call Beacon directly at 855-765-9700 (TTY: Dial 711). Beacon 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.
Medi-Cal Rx: Frequently Asked Questions (FAQ) for Your Medi-Cal Prescription Drug Benefit
Starting on January 1, 2022, your prescriptions that are filled at a pharmacy will be covered by Medi-Cal Rx. Medi-Cal Rx is a new program provided by the California Department of Health Care Services (DHCS) to help you with your pharmacy needs.
Starting on January 1, 2022, Medi-Cal Rx will be your new prescription drug benefit provider, not the Alliance.
You will need to show your Medi-Cal Benefits Identification Card (BIC) when filling a prescription at the pharmacy.
Most members will not have to change their medications.
The approved drug list (formulary) and list of drugs that require prior approval for Medi-Cal Rx may be different than what the Alliance uses. Your doctor will discuss with you if they think you may need to change your medications.
Most pharmacies will accept Medi-Cal Rx.
Before January 1, 2022, you can call the Medi-Cal Member Help Line at 800-541-5555 (TTY: 800-430-7077) to ask if your pharmacy will accept Medi-Cal Rx.
If you need help finding a pharmacy on or after January 1, 2022, use the Medi-Cal Rx Pharmacy Locator online at www.medi-calrx.dhcs.ca.gov or call Customer Service at 800-977-2273 (TTY:711) 24 hours a day, 7 days a week.
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.
On or before December 31, 2021, if you have general questions about Medi-Cal Rx, call the Medi-Cal Member Help Line at 800-541-5555 (TTY: 800-430- 7077), Monday through Friday, 8 a.m. to 5p.m.
Starting on January 1, 2022, if you have questions about your prescription drugs or pharmacy benefits, you can call the Medi-Cal Rx Call Center Line at 800-977-2273 (TTY: 711) 24 hours a day, 7 days a week. Or, for more information, visit the Medi-Cal Rx website at www.medi-calrx.dhcs.ca.gov.
On or after January 1, 2022, if you are not happy with the services Medi-Cal Rx provides, you can file a complaint with Medi-Cal Rx anytime in writing or by phone.
- Visit www.medi-calrx.dhcs.ca.gov
- Call Medi-Cal Rx Customer Service at 800-977-2273
Yes. The Alliance will continue managing your DME benefit.
Contact Member Services
- Monday through Friday, from 8 a.m. to 5:30 p.m.
- Phone: 800-700-3874
- Deaf and Hard of Hearing Assistance
Alliance TTY Line: 877-548-0857
- Nurse Advice Line