Question 1

What is Medi-Cal?

Accepted Answer

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.

Question 2

Who is the Alliance?

Accepted Answer

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 Mariposa, Merced, Monterey, San Benito 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.

Question 3

How do I get started with Medi-Cal?

Accepted Answer

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:

For the Hearing or Speech Assistance Line, call 800-735-2929 (TTY: Dial 711).

Question 4

What is Alliance Care IHSS?

Accepted Answer

Alliance Care IHSS is a health plan for people who provide in-home support services in Monterey County. The plan provides care for eligible people who are registered with the Monterey County Public Authority for In-Home Supportive Services (the Public Authority).

To enroll in Alliance Care IHSS, you must meet all of the requirements. This means:

You must meet Public Authority work requirements.
You must live or work in Monterey County.
You must not have been terminated by Central California Alliance for Health (the Alliance) in the past for fraud, deception or failing to give complete information.

Learn more on our Alliance Care IHSS page.

Note: If you are looking for in-home support services (IHSS), this is different than the Alliance Care IHSS health plan. To learn about getting in-home support services in your county, go to the California Department of Social Services website.

Question 5

How do I change my contact information?

Accepted Answer

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:

Mariposa County

209-966-2000

800-549-6741

Merced County

209-385-3000

855-421-6770

Monterey County

877-410-8823

San Benito County Health

831-636-4180

Santa Cruz County

888-421-8080

Question 6

Will my Medi-Cal eligibility change with a new president?

Accepted Answer

The Alliance does not determine or change Medi-Cal eligibility.

For information about your Medi-Cal edibility, contact your county's Department of Social Services or Health Services Agency. If you have Medi-Cal, your county must tell you if there are any changes to your coverage.

Make sure your contact information is up to date so you get the updates you need. The Alliance website will also have news and information about Medi-Cal benefits and no-cost programs.

Question 7

I have both private health insurance and the Alliance. Which insurance is my primary one?

Accepted Answer

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.

Question 8

My private health insurance has ended but I still have insurance from the Alliance. Who should I call?

Accepted Answer

Call Member Services at the Alliance to report this change. You can also report this change through the DHCS website.

Question 9

I have both Medi-Cal and the Medicare. Which is my primary insurance and what's covered?

Accepted Answer

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
You do not need an authorization from the Alliance for hospital care.
You can go to any doctor that takes Medicare, unless you are in a Medicare Advantage Plan.
Medicare has an annual deductible and co-insurance.

Medi-Cal will always be your secondary health insurance
If your doctor accepts Medi-Cal as your secondary health insurance, he or she will bill the Alliance for the deductible and co-insurance.
You will not need to pick an Alliance doctor.
You can go to any Medicare doctor who will bill the Alliance.

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.

Question 10

Can I change my doctor? Who do I call?

Accepted Answer

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.

Question 11

I have a total of three children. Two are assigned to the same doctor and my third child was assigned to a different doctor. Can they be assigned to the same doctor?

Accepted Answer

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.

Question 12

I’m unhappy with my provider. What can I do about it?

Accepted Answer

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).

Question 13

How can I receive a Medi-Cal Benefits Identification Card (BIC)?

Accepted Answer

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.

Question 14

I lost my Alliance Member ID card. How can I get a new one?

Accepted Answer

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. When you call Member Services, you can ask for a printed ID card, a digital ID card or both. You can get a digital copy of your Member ID card sent to your smartphone while you are on the phone with Member Services.

If you think your wallet was stolen and it had your Medi-Cal ID in it, call your local police office.

You can call your county’s Human Services Agency to get a new Medi-Cal ID number:

Mariposa County Health and Human Services Agency: 209-966-2000 or 800-549-6741 (TTY: Dial 711).
Merced County Human Services Agency: 209-385-3000 or 855-421-6770 (TTY: Dial 711).
Monterey County Social Services Department: 831-755-4448 or 877-410-8823 (TTY: Dial 711).
San Benito County Health and Human Services Agency, Public Assistance: 831-636-4180 (TTY: Dial 831-634-4969).
Santa Cruz County Human Services Agency: 888-421-8080 (TTY: Dial 711).

To keep your medical identify safe and make sure no one else uses your Medi-Cal ID, you can check your billing information at no cost to you. Call Member Services at 800-700-3874 and ask for a Records Access Request Form. If you get a bill for services you didn’t get, you can make a complaint. Call Member Services at 800-700-3874 for help.

Question 15

Can the Alliance provide me with transportation to my medical appointments?

Accepted Answer

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.

Question 16

Can I get dental coverage?

Accepted Answer

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.

Question 17

Is my vision covered?

Accepted Answer

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.

Question 18

How do I access mental health or behavioral health services?

Accepted Answer

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.

Question 19

I have Medi-Cal insurance from the Alliance, but I was sent a bill. Who can I talk to?

Accepted Answer

If you got a bill for a covered service, please call Member Services at the Alliance right away.

Question 20

I started to get texts from the Alliance. Are these texts safe?

Accepted Answer

In September 2024, the Alliance started to text members about benefits, services and other important topics.

We already texted members when they need to renew their Medi-Cal. Now, the Alliance will also text about other updates and topics. Alliance texts will come from the short code 59849.