Your Rights And Responsibilities

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Questions




For more information about OneCare Connect or to enroll, please call us at:

1-855-705-8823 (toll free)

24 hours a day/ 7 days a week.

Or visit our office Monday through Friday from 8 a.m. to 5 p.m. Pacific Time (walk-ins welcome).

Members with hearing or speech impairments can call our 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

ما پرسنلی را در استخدام داریم که به زبان شما تکلم می کنند.

여러분의 언어를 하는 직원이 있습니다.

Your Rights As A OneCare Connect Member

OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) brings all your health care needs together to make getting quality care easier. We want you to understand your benefits and know your rights as a OneCare Connect member.

Your Right To File A Grievance Or Appeal

In case you ever have concerns about the health care services you get, you have the right to file a grievance or appeal. OneCare Connect will not discriminate against you or limit your benefits in any way if you express concerns or file a complaint.

Your Rights And Responsibilities

As a OneCare Connect member, you have rights and responsibilities. These are the standards we promise to you and your responsibilities as a member in turn.

Your Rights And Responsibilities Upon Disenrollment

No one can make you stay in our plan if you do not want to. You can leave our plan at any time. If you leave our plan, you will still be in the Medicare and Medi-Cal programs. You have the right to get most of your health care services through Original Medicare or a Medicare Advantage plan. You can get your Medicare Part D prescription drug benefits from a prescription drug plan or from a Medicare Advantage plan. Your Medi-Cal benefits will continue to be offered through CalOptima. To learn more about your rights and responsibilities upon disenrollment, see Chapter 10 of the OneCare Connect Member Handbook.

Your Right To Privacy

OneCare Connect 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.

How To Appoint A Representative

If you wish to have someone represent you other than your doctor, you must complete the Appointment of Representative Form and include the form with your grievance, coverage or drug exception request, or your appeal.

Report Fraud or Abuse

You Can Report Fraud or Abuse. If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-877-837-4417 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraud activity.

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

H8016_19MM027_M Accepted (09/25/18)

OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Limitations, co-pays, and restrictions may apply. For more information, call OneCare Connect Customer Service or read the OneCare Connect Member Handbook. Benefits and/or copayments may change on January 1 of each year. Copays for prescription drugs may vary based on the level of Extra Help you receive. Please contact the plan for more details. Other Pharmacies/Physicians/Providers are available in our network. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you. OneCare Connect complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. You can get this information for free in other languages. Call toll-free 1-855-705-8823. TDD/TTY users can call 1-800-735-2929. The call is free.

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