How To Choose A Provider

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If you have questions or need help with your health care, please call our Customer Service Department at:

1-877-412-2734 (toll free)
1-714-246-8711 (fax)

24 hours a day/ 7 days a week.

Members with hearing or speech impairments can call the TDD/TTY line at 1-800-735-2929.

We also provide interpreter services at no cost to our members.

We have staff who speak your language.

Tenemos personal que habla su idioma.

Chúng tôi có nhân viên nói cùng ngôn ngữ với quý vị

Choose a Doctor and Health Network

What is a Primary Care Provider (PCP)?

When you become a member of OneCare (HMO SNP), you must choose a plan provider to be your primary care provider (PCP). Your PCP is a physician who meets state requirements and is trained to give you basic medical care. As we explain below, you will get your routine or basic care from your PCP. Your PCP will also coordinate the rest of the covered services you get as a plan member. For example, in order to see a specialist, you usually need to get your PCP’s approval first (this is called getting a “referral” to a specialist).

How do you choose a PCP?

  • At the time of your enrollment into OneCare, you will receive a OneCare Provider Directory. This directory gives you a listing of all medical groups, PCPs, specialists, and hospitals contracted with OneCare to provide services to OneCare members.

  • The PCPs are listed in the provider directory by city. Choose a PCP from this list. Listed below the PCP’s phone number are the medical groups the PCP is with. If the PCP is with more than one Medical Group, choose one of the Medical Groups.

  • OneCare will send you a letter to confirm your PCP choice. The letter will give you the address and phone number to contact your PCP. Your PCP’s name and phone number will also be printed on your OneCare membership
    ID card.

You may choose any of the doctors listed in the “Primary Care Physicians” section of the as your PCP. We will do our best to give you the PCP you want. We will let you know if the PCP you chose is not open to new members. If there is a particular OneCare specialist or hospital that you want to use, check first with your PCP or the OneCare Customer Service department to be sure your PCP makes referrals to that specialist or uses that hospital.

If you do not pick a PCP, OneCare will choose one for you. You can request a PCP change at any time, If you need help choosing a PCP call OneCare Customer Service Department toll-free at 1-877-412-2734, or TDD/TTY 1-800-735-2929 24 hours a day/ 7 days a week.

Date Revised September 2, 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.

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