New Members Start Here

CalOptima Health’s website makes it easier for you to find what you need using any device. A secure online member portal lets you:

A PCP is a health care provider who is responsible for your routine medical care. A health network is a group of doctors and hospitals that provide your health care services.

You must choose a PCP and HN from the Provider Directory within 30 days of enrolling in CalOptima Health. If you don’t choose an HN after 30 days of becoming a member, CalOptima Health will choose one for you. You may change your PCP and HN every 30 days.

To select your PCP and HN, you can:

The Member Handbook tells you about your coverage under CalOptima Health. Please read it carefully and completely. It will help you understand the benefits and services available to you and how to get the care you need. It also explains your rights and responsibilities as a CalOptima Health member.

CalOptima Health recommends scheduling your first visit with your new PCP within 120 days for an IHA. The IHA helps your PCP learn about your health care history and needs. Your PCP might ask questions about your health or have you fill out a questionnaire. Your PCP will also tell you about health education counseling and classes that can help you.

See your doctor as soon as you think you are pregnant to begin prenatal care. Ask your doctor about Perinatal Support Services. This program gives you more information during your pregnancy and for 2 months after your baby is born.

Depending on your situation, you may qualify for either medical transportation or non-medical transportation. These services are not for emergencies and may be free.

You can get medical transportation if you have medical needs that don’t allow you to use a car, bus or taxi to your appointments. You can get medical transportation by ambulance, litter van, wheelchair van or air transport for covered services and Medi-Cal-covered pharmacy appointments. You can request medical transportation by asking your doctor, dentist, podiatrist or mental health or substance use disorder provider for it. Your provider will decide the correct type of transportation to meet your needs.

You can get non-medical transportation to your appointments when the appointment is for a Medi-Cal-covered service, and you don’t have access to transportation. CalOptima Health allows you to use a car, taxi, bus or other public or private way to get to your medical appointment for Medi-Cal-covered services. You can get a ride for free when you have tried all other ways to get transportation.

What is the CalOptima Health Medi-Cal transportation phone number?
To request a ride for authorized services, call CalOptima Health’s transportation line at 1-833-648-7528 (TTY 711) at least 2 business days (Monday–Friday) before your appointment. Or call as soon as you can when you have an urgent appointment. Have your member ID card ready when you call.

The Medi-Cal Dental Fee for Service (FFS) Program is the same as FFS Medi-Cal for your dental services. Before you get dental services, you must show your state-issued Medi-Cal Benefits Identification Card (BIC) to the dental provider. Make sure the provider takes FFS Dental and you are not part of a managed care plan that covers dental services. Medi-Cal covers many different dental services through the Medi-Cal Dental Program.

Medi-Cal vision coverage includes:

Yes. For medical appointments, use your CalOptima Health Medi-Cal member ID card. For other services such as dental, vision and pharmacy, use your state-issued Medi-Cal BIC.

After choosing your PCP, call their office directly to schedule appointments. If you need help, call CalOptima Health Customer Service at 1-714-246-8500 or toll-free at 1-888-587-8088 (TTY 711).