As a new CalOptima member, you will need to:
A health network is a group of doctors and hospitals that provides health care services. CalOptima’s health networks are listed in the Health Network and Provider Directory, which is sent to all new CalOptima members.
You may choose the same health network for you and your eligible family members. If you would like to choose a different health network for each family member, call CalOptima’s Customer Service Department at 1-714-246-8500 or toll-free at 1-888-587-8088. If you do not choose a health network after 30 days of becoming a member, CalOptima will choose one for you.
Choose a PCP from the Health Network and Provider Directory. You must choose a PCP that is contracted with the health network you choose. You can choose a different PCP within the same health network for each eligible family member. You may change your PCP every 30 days.
The Health Network Selection Form is included in your new member packet. You must list your choice of health network and PCP, sign the form, and return it to CalOptima as soon as possible.
Your CalOptima Member Handbook has important information about CalOptima’s programs and services. Refer to your handbook to find out what benefits are covered, how to change your health network, how to change your PCP, and for other information about your health care services.
The first health exam for you and/or your Medi-Cal-eligible children should be scheduled within 120 days (4 months) of becoming a CalOptima member.
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