Below are some common questions and answers about CalOptima and OneCare (HMO SNP). If you do not see your question answered here, please call our Customer Service Department. We are here to help you and make sure you get access to the best health care possible.
OneCare is a Medicare Advantage Plan that combines your Medicare, prescription drug, and Medi-Cal benefits into one plan. OneCare is a program offered through CalOptima.
You can enroll in OneCare if you have Medi-Cal and Medicare Parts A and B, and live in Orange County, California.
OneCare offers the benefits of Medicare, Medi-Cal and more in one program.
Yes, based on an approved formulary which may change from year to year. Some drugs may require prior authorization, step therapy, or quantity limits
Yes. Vision includes eye exams and eyewear, but there are some limits. Please contact OneCare for details.
With many health plans, it’s hard to understand and use the benefits, even more when you have Medicare and Medi-Cal. With OneCare your Medicare and Medi-Cal benefits are together in one health plan.
There is no cost to enroll in OneCare. OneCare members do not pay plan premiums, or deductibles. OneCare members whose services are approved do not pay a co-pay or co-insurance. OneCare members may have co-payments for some prescription drugs. Please contact OneCare for more details.
Yes. OneCare members can choose from a large network of doctors in Orange County. OneCare also has a selection of hospitals in your area.
You can use OneCare’s taxi benefit for a set number of rides to and from your doctor visits at no cost to you. Members who need special accommodations may qualify for other non-emergency medical transportation.
For more information about OneCare (HMO-SNP) or to enroll, please call us at 1-877-412-2734 (toll-free). TDD/TTY users may call 1-800-735-2929.
Date Revised September 29, 2016
To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.H5433_WEB1004 Approved (11/15/16) OneCare (HMO SNP) is a Medicare Advantage organization with a Medicare contract. Enrollment in OneCare depends on contract renewal. Eligible beneficiaries can enroll at any time. Eligible beneficiaries must have Part A and Part B to enroll in the plan. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other Pharmacies/Physicians/Providers are available in our network. Medicare beneficiaries may also enroll in OneCare (HMO SNP) through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Medicare has neither reviewed nor endorsed this information. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. OneCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. This information is available for free in other languages. Please call our customer service number at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users should call 1-800-735-2929. Materials available on this Website in PDF format may require the free Adobe Reader to view. To download Adobe Reader for free from the Adobe Website,click here.
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