We Speak Your Language

Welcome To OneCare (HMO SNP)!

OneCare (HMO SNP) means total care. All your Medicare and Medi-Cal benefits are covered in one single plan making it easier to get the health care you need. With OneCare from CalOptima, you can choose from more than 2,800 physicians in Orange County who are ready to serve you.

We provide prescriptions, vision coverage, and many other benefits, such as transportation to and from your medical appointments.

To be a member of CalOptima OneCare, you must:

  • Live in Orange County

  • Be enrolled in Medi-Cal and Medicare Parts A and B

For more information about OneCare or help with your health care, please call OneCare Customer Service toll-free at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users can call toll-free at 1-800-735-2929. Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Walk-ins are welcome. We have staff who speak your language.

Important Documents For OneCare Members

Your health is important to us. We are here to help you understand and access all your benefits as a OneCare member. The documents below explain your rights, your benefits, how to get care and more. If there are documents not listed that you would like in your language, please call OneCare Customer Service toll-free at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users can call toll-free at 1-800-735-2929. Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Walk-ins are welcome. We have staff who speak your language.

Language Assistance Services PDF File Indicator Image
We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call OneCare Customer Service toll-free at 1-877-412-2734. Someone who speaks your language can help you. This is a free service.

Notice of Non-DiscriminationPDF File Indicator Image

2018 OneCare Plan RatingPDF File Indicator Image

2019 OneCare Plan RatingPDF File Indicator Image

Enrollment Information

OneCare Enrollment Form PDF File Indicator Image
If you want to apply to become a OneCare member, complete and return this form to OneCare.

New Member Orientation Schedule
New to OneCare? Attend a New Member Orientation to learn how to get the most from your benefits.

2018 Benefits Information

2018 OneCare Summary of Benefits PDF File Indicator Image
The Summary of Benefits provides you with a brief overview of the benefits to which you have as a OneCare member.

2018 OneCare Evidence of Coverage PDF File Indicator Image
The Evidence of Coverage is a comprehensive guide to all of your benefits as a OneCare member, including information about what is covered, how to get services, your rights as a member, your responsibilities and more.

2018 OneCare Provider and Pharmacy Directory PDF File Indicator Image
Use the Provider and Pharmacy Directory to find a covered doctor, specialist, pharmacy or other provider near you.

2019 Benefits Information

2019 OneCare Annual Notice of ChangePDF File Indicator Image

2019 OneCare Summary of Benefits PDF File Indicator Image
The Summary of Benefits provides you with a brief overview of the benefits to which you have as a OneCare member.

2019 OneCare Evidence of Coverage PDF File Indicator Image
The Evidence of Coverage is a comprehensive guide to all of your benefits as a OneCare member, including information about what is covered, how to get services, your rights as a member, your responsibilities and more.

2019 OneCare Provider and Pharmacy Directory PDF File Indicator Image
Use the Provider and Pharmacy Directory to find a covered doctor, specialist, pharmacy or other provider near you.

Notice of Privacy Practices

CalOptima has a privacy policy that explains the steps we take to keep your personal information private. It also describes how and when we might share your health information with others.

View the Notice of Privacy PracticesPDF File Indicator Image

How to File a Grievance

As a OneCare member, we want to hear your concerns about the health care services you get. We want you to talk with your doctor or health network if you have any questions about your health care. If this is not possible, or you need help, please call OneCare Customer Service toll-free at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users can call toll-free at 1-800-735-2929. Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Walk-ins are welcome. We have staff who speak your language.

How to File an Appeal or Grievance

Common Forms

OneCare wants to make it easier to get the health care you need. Listed below are forms you may use when talking to OneCare or your doctors. If you can’t find what you are looking for, please call OneCare Customer Service toll-free at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users can call toll-free at 1-800-735-2929. Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Walk-ins are welcome. We have staff who speak your language.

Printed OneCare Connect Prescription Drug Determination Request FormPDF File Indicator Image

Appeals and Grievance FormPDF File Indicator Image

Appointment of Representative FormPDF File Indicator Image

Authorization for Release of Protected Health Information (PHI)PDF File Indicator Image

Instruction Sheet for CalOptima Health Insurance Portability and Accountability Act (HIPAA) Authorization for Release of Protected Health Information (PHI)PDF File Indicator Image

Enrollment FormPDF File Indicator Image

Individual Request for Protected Health Information (PHI) AccessPDF File Indicator Image

Member Request to Amend Protected Health Information (PHI)PDF File Indicator Image

Request for an Accounting of DisclosuresPDF File Indicator Image

Request for Restriction on Manner/Method of Confidential CommunicationsPDF File Indicator Image

Request for Restriction on Use and Disclosure of Protected Health Information (PHI)PDF File Indicator Image

Statement of Disagreement PDF File Indicator Image

Suspected Fraud or Abuse Referral FormPDF File Indicator Image

We Speak Your Language

At OneCare, we believe in the importance of providing services that are sensitive to the needs of the community. We want to make sure you have access to the best health care possible. OneCare respects you, your culture and your beliefs. We want you to feel comfortable talking with us and your health care providers.

To Make It Easier For You, OneCare Provides:

  • Bilingual staff to help you in your language

  • Interpreter services, including American Sign Language, at no cost to you for all of your health care needs. You do not need to ask friends or family members to interpret for you. You can get interpreter services 24 hours a day, 7 days a week for:
    Medical services: doctor visits, after-hours services, urgent care services, pharmacy services and health education classes

    Non-medical services: customer service, member complaints and member orientation meetings

  • Health education and enrollment materials printed in several languages at no cost to you

  • Upon request, materials in other formats, such as braille, audio or large print

All you need to do is call your health network or OneCare. For scheduled appointments, make sure to ask for an interpreter at least 5 working days before your appointment.

To reach us, please call OneCare Customer Service toll-free at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users can call toll-free at 1-800-735-2929. Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Walk-ins are welcome. We have staff who speak your language.

To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_19MM027_M Accepted (09/25/18)

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.

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