Alliance Care In-Home Supportive Services (IHSS)

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.

The Public Authority will let you know when you can enroll in the plan. They will give you with an application. You must fill out the application and return it to the Public Authority as soon as you are told to do so. 

You must choose a primary care provider (PCP) when you enroll. If you do not choose a PCP when you enroll, we will choose one for you.

If you do not have a PCP, you can find one in our Online Provider Directory. You can also download the IHSS Provider Directory for a printable version. If you have not seen your new PCP, make a new patient appointment within 120 days after you enroll.

You must get services from a participating provider. Your doctor will need to get approval (called prior authorization) before giving you certain services.

• For a high-level summary of plan benefits, read the Benefits Matrix.
• For a detailed summary, read the Summary of Benefits and Coverage.
• For full details, read the Alliance Care IHSS Member Handbook.

Once you are enrolled, you must pay a monthly premium (cost). The Public Authority will tell you:

• How much your premium costs.
• How to make a payment.

You can call the Public Authority at 831-755-4466 (TTY: 831-784-2131) to learn more about:

• Eligibility.
• Enrollment.
• Premiums.
• When your coverage starts.

There is no deductible for covered services. To learn more about covered services, see the "Benefit Descriptions" section of the Alliance Care IHSS Member Handbook Combined Evidence of Coverage.

Alliance Care IHSS members have an annual out-of-pocket maximum of $3,000 per benefit year. All copayments you use to pay for covered services will count toward the annual $3,000 out-of-pocket maximum. A copayment is a fixed dollar amount that you pay for a covered health service.

The Alliance keeps track of all copayments. We send Alliance Care IHSS members accrual notices. These notices show the up-to-date copayments that count toward the annual out-of-pocket maximum. Notices are sent when members access services for the current benefit year.

As a member, you have the choice to opt out of this mailing. Call Member Services to get accrual notices by email instead. You can also opt out of getting any notices.

Once you meet your annual out-of-pocket maximum for the benefit year, the Alliance will send you a new ID card.

Premium payments do not count toward the annual out-of-pocket maximum. Learn more about copayments in the "Benefit Descriptions" section of the Alliance Care IHSS Member Handbook Combined Evidence of Coverage.

Alliance Care IHSS members can use the price transparency tool to see how much a copayment for a covered service will cost before they get care. You can also see how much the Alliance reimburses in-network providers. Copayment amounts will vary based on the location of the service.

For example:

• A service you get at an office could cost you $10.
• A service you get at the emergency room could cost you $25.
• A service you get through an inpatient hospital admission could cost you $0.