Meet your local Medi-Cal plan for Mariposa and San Benito counties
If you have questions or need help, call the Alliance’s Member Services at 800-700-3874 (TTY: 800-735-2929 (Dial 711). We are available from 8 am to 5:30 pm, Monday through Friday.
Beginning January 1, 2024, the Alliance will be available to people in Mariposa and San Benito counties who are eligible for Medi-Cal.
Central California Alliance for Health (the Alliance) is a managed care health plan for people who have Medi-Cal.
For nearly 30 years, we have served members in Merced, Monterey and Santa Cruz counties. We live and work in the communities we serve. We also speak our members’ languages and seek to understand their cultural backgrounds.
We help our members:
- Understand their health insurance plan.
- Find health care providers.
- Know about available services and community resources.
- Learn how to manage chronic health conditions.
Find answers to your health insurance questions in the below areas. Please call Member Services for help.
Eligibility and enrollment
Getting care
There are three ways to see if you can keep seeing your current doctors:
- Call Member Services and ask if your doctors work with the Alliance. You can also check to see if your doctor is listed in our Provider Directory.
If they do, you can keep your doctor. If they don't, you can ask if you can keep your doctors for a limited time. You can only keep them for up to 12 months.
- Ask your doctor to call the Alliance and ask to keep you as their patient.
- Ask a family member or person representing you to call the Alliance. They can make a request for you as your authorized representative. The Alliance may ask you directly if you are okay with this person representing you.
If you had a doctor before you were a member of the Alliance, and that doctor is not part of the Alliance network, you may be able to keep going to that doctor for a limited time. This is called continuity of care. When it’s time to choose a doctor that is part of the Alliance network, you can find one through our Provider Directory. If you have questions, call Member Services.
For urgent care inside the Alliance service area, you must visit an Alliance network urgent care provider. You do not need pre-approval to get urgent care from an in-network provider. You may have to pay for the urgent care you get from an out-of-network provider inside the Alliance service area if you do not get pre-approval. Call the 24/7 Nurse Advice Line first to see if you need an urgent visit. The number to call is 844-971-8907 (TTY: Dial 711).
If you have a life-threatening medical emergency, you may visit any emergency room or dial 911.
Under certain circumstances members may be allowed to use their existing durable medical equipment (DME) provider for a limited amount of time. Call Member Services with any questions about DME or medical supplies.
The Alliance will allow members to stay in the same skilled nursing facility (SNF), long-term care (LTC) or subacute unit under continuity of care under certain conditions. Call the Alliance Member Services with any questions about LTC, SNF or Sub-Acute care services.
You will be able to get the same benefits and services that you were eligible for through Medi-Cal fee-for-service or through your previous Medi-Cal managed care plan. The Member Handbook lists the benefits and services you are able to get through the Alliance.
Pharmacy and medications
If you already had Medi-Cal, you won’t need to change your medications. If you have questions, visit the Medi-Cal Rx website or call 800-977-2273.
Members can use the same pharmacy if the pharmacy accepts Medi-Cal Rx.
Visit www.medi-calrx.dhcs.ca.gov and use the “Find a Medi-Cal Rx Pharmacy” tool to search for pharmacies. You can also search under the tab at the top of the page “Tools & Resources” and select “Find a Pharmacy.”
Medi-Cal Rx takes care of everything related to prescription drugs.
Authorization and referrals
If the service or appointment is for a serious medical condition that is medically necessary, then the Alliance must allow you to keep the service. If the service or appointment is not for a serious medical condition but is medically necessary, the Alliance must arrange for you to either keep the appointment or schedule an appointment with an Alliance provider.
Call your doctor and let them know you are now a member of the Alliance. They will let you know if a new authorization or referral is needed. You can also call the Alliance’s Member Services for more information.
Claims and billing
You can call Member Services for help. You can also stop by the Alliance office and speak to a Member Services Representative. It is helpful if you bring your bill with you.
The Alliance would not deny or change a service received prior to you becoming an Alliance member. The Alliance will handle claims for service dates beginning on January 1, 2024. Any services you have before January 1, 2024 will be handled by your prior health insurance.
If your questions are not answered on this page, please visit our Frequently Asked Questions page for members. You can also call Alliance Member Services for help.
Contact Member Services
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