CalOptima Health OneCare (HMO D-SNP) Combines Your Medicare and Medi-Cal Benefits
To qualify to be a OneCare member you must:
- Live in Orange County
- Have Medicare Parts A and B
- Have full Medi-Cal with no Share of Cost
- Be age 21 or older
Choose the OneCare Option That’s Right For You
Choose from one of our two OneCare options to get full health care. Our OneCare Complete plan offers support for your unique needs, while our OneCare Flex Plus plan enhances your care with more flexible benefits. Both options bring your Medicare and Medi-Cal benefits together, so you can focus on what’s most important — your health.
OneCare Complete
Flex Card: Over-the-Counter (OTC) and groceries
$135 per quarter and no rollover of unused funds
Prescription Medicines (Part D premium coverage)
No copays
Vision
Annual exam and up to $300 for eyeglasses or contact lenses every year
Hearing
$1,000 of hearing hardware above the Medi-Cal limit of $1,510
Comprehensive Dental**
Yes
Fitness benefit
Yes
Transportation
Unlimited trips to/from the gym and 100 one-way trips to grocery stores (10-mile radius)
Worldwide emergency room coverage
$100,000
Annual physical exam
Once per 12 months
In-Home Support Services — Companion Care
Up to 90 hours
Erectile Dysfunction Medicines
—
OneCare Flex Plus
Flex Card: Over-the-Counter (OTC) and groceries
$135 per quarter and no rollover of unused funds
Prescription Medicines (Part D premium coverage)
No copays
Vision
Annual exam and up to $300 for eyeglasses or contact lenses every year
Hearing
$1,000 of hearing hardware above the Medi-Cal limit of $1,510
**
Yes
Fitness benefit
Yes
Transportation
Unlimited trips to/from the gym and 100 one-way trips to grocery stores (10-mile radius)
Worldwide emergency room coverage
$100,000
Annual physical exam
Once per 12 months
In-Home Support Services — Companion Care
Up to 90 hours
Erectile Dysfunction Medicines
—
*The CalOptima Health OneCare Flex Plus grocery benefit is part of a special supplemental program for the chronically ill. Not all members qualify. To use the grocery benefit, CalOptima Health OneCare Flex Plus members must have one or more comorbid and medically complex chronic conditions that are life threatening or significantly limits the overall health or function of the enrollee. Eligible conditions include but are not limited to cardiovascular disorder, diabetes mellitus, chronic heart failure, chronic lung disease or end-stage renal disease. Even if the member has a chronic condition, the member will not necessarily receive the grocery benefit. Receiving the grocery benefit depends on the member having a high risk of hospitalization or other adverse health outcomes and a need for intensive care coordination.
Use this form to find out if you qualify to buy groceries with your Flex Card. Print this form and ask your doctor to fill it out.
Flex Card Grocery Benefit form
Comprehensive Dental
**CalOptima Health OneCare works with Liberty Dental Plan to provide you with comprehensive dental services that add to the services you can get through Medi-Cal Dental. Click below for more information about which dental services CalOptima Health OneCare covers and how they work.
CalOptima Health OneCare Dental Benefits and Medi-Cal Dental Benefits
Liberty Dental Plan Frequently Asked Questions
For a full list of services covered by Medi-Cal Dental, call 1-800-322-6384 (TTY 1-800-735-2922) or visit Smile, California. These resources can also help you locate a Medi-Cal Dental provider and file a grievance or complaint.
Let us Support Your Health
Rest easy — with OneCare, our team will help you plan services and benefits that best fit your health care needs. We’ll support you with:
Personal Care Coordinator (PCC)
Someone to answer your questions and plan your health care
Health Assessment
A survey to help us understand and support your current medical and social needs
Care Team
The people who know your health care best and who work together to support your care
Care Plan
A document that organizes and guides your care needs
Attend a OneCare Info Session
Join one of our information sessions to see if OneCare is right for you. Call 1-877-412-2734 (TTY 711) to RSVP.
OneCare Info Sessions
Enrolling in OneCare Is Simple and Easy!
You can download an enrollment form and mail it to the address below. For more information, please call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711), 24 hours a day, 7 days a week. We have staff who speak your language. Print and complete the enrollment form to apply for OneCare and mail it to:
CalOptima Health
Attention: OneCare Customer Service
505 City Parkway West
Orange, CA 92868
New CalOptima Health OneCare Members: Start Here
CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan, combines your Medicare and Medi-Cal benefits in a single plan, making it easier to get the health care you need. With OneCare, you can choose from more than 1,500 doctors and specialists in Orange County who are ready to serve you.
What to Expect After Enrolling
Confirmation Letter With Your Effective Date of Coverage
Within 10 days of enrolling, you’ll get a confirmation of enrollment letter in the mail. You should keep this letter. It serves as proof that Medicare has approved your enrollment form.
Welcome Kit and Member ID Card
You’ll get a welcome kit from CalOptima Health OneCare that has your member ID card. Be sure to bring your new member ID card when you visit your doctor, hospital and pharmacy.
Flex Card Benefit Information
You’ll get a debit card and instructions on how to use it.
Expect a Health Assessment Phone Call
You’ll get a call from a CalOptima Health OneCare Personal Care Coordinator (PCC) who will ask about your health history, your current health status and the services you may need. Your answers will help us get the right care for you.
Important Steps for New Members
Sign up to Access Your CalOptima Health OneCare Member Portal
CalOptima Health’s website makes it easier for you to find what you need using any device. A secure online member portal lets you:
- Update your personal information
- Request a new ID card
- Print a copy of your ID card
- Change your health network or primary care provider (PCP)
- Request interpreter services
How to sign up and log in to your OneCare member portal
Learn About Your OneCare Benefits
The CalOptima Health OneCare Member Handbook, also known as the OneCare Evidence of Coverage, tells you what’s covered under our plan. It explains health care services, behavioral health (mental health and substance use disorder) services, prescription drug coverage, and long-term services and supports.
- To get a complete list of services we cover, view the Member Handbook.
- If you want a Member Handbook mailed to you, or have benefit questions, please call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711), 24 hours a day, 7 days a week
Schedule Your Appointment
CalOptima Health OneCare recommends scheduling your first visit with your new PCP within 90 days. This visit helps your PCP learn about your health care history and needs. Your PCP might ask questions about your health or have you fill out a questionnaire. Your PCP will also tell you about health education counseling and classes that can help you.
Other Important Information
If you are pregnant and have CalOptima Health OneCare
See your doctor as soon as you think you are pregnant to start prenatal care. Ask your doctor about Perinatal Support Services. This program gives you more information during your pregnancy and for 2 months after your baby is born.
If you need transportation and have OneCare
Depending on your situation, you may qualify for either non-emergency medical transportation or non-medical transportation. These services are not for emergencies and are available at no cost to you.
Non-emergency medical transportation
You are entitled to non-emergency medical transportation if you have medical needs that don’t allow you to use a car, bus or taxi to your appointments. Non-emergency medical transportation can be provided by ambulance, litter van, wheelchair van or air transport for your medical needs when you need a ride to your appointment. If you need non-emergency medical transportation, you can talk to your PCP and ask for it. Your PCP will decide the best type of transportation to meet your needs.
Non-medical transportation
You can get non-medical transportation to and from your appointments for a service authorized by your provider. You can get a ride, at no cost to you, when you:
- Travel to and from an appointment for a service authorized by your provider, or
- Pick up prescriptions and medical supplies.
OneCare allows you to use a car, taxi, bus or other public/private way to get to your non-medical appointment for services authorized by your provider. We cover the lowest-cost, non-medical transportation type that meets your needs.
What is the CalOptima Health OneCare transportation phone number?
To ask for a ride for authorized services, call the transportation line at 1-866-612-1256 (TTY 711) at least 2 business days (Monday–Friday) before your appointment. For urgent appointments, call as soon as possible. Have your Member ID Card ready when you call. You can also call if you need more information.
New Member Orientation
Welcome to our OneCare health plan! We encourage you to attend our new member orientation to learn about:
- Your benefits
- How to get medical services and medicines
- How to use resources in your community
View our New Member Orientation presentation and see our upcoming orientation sessions below. To sign up for an orientation session, request an interpreter or for questions, please call our CalOptima Health OneCare Customer Service team at 1-877-412-2734 (TTY 711) 24 hours a day, 7 days a week.
OneCare New Member Orientation Sessions
Review OneCare Member Documents
OneCare Complete
See important documents for members enrolled in CalOptima Health OneCare Complete (HMO D-SNP), a Medicare Medi-Cal Plan.
2025 Provider and Pharmacy Directory (Updated 3/17/2025)
2025 Member Handbook (Updated 9/4/2024)
2025 Summary of Benefits (Updated 8/1/2024)
2025 List of Covered Drugs (formulary)
2025 Over-the-Counter (OTC) Catalog and Ordering Instructions
OneCare Flex Plus
See important documents for members enrolled in CalOptima Health OneCare Flex Plus (HMO D-SNP), a Medicare Medi-Cal Plan.
2025 Provider and Pharmacy Directory (Updated 3/17/2025)
2025 Member Handbook (Updated 9/4/2024)
2025 Summary of Benefits (Updated 8/1/2024)
2025 List of Covered Drugs (formulary)
2025 Over-the-Counter (OTC) Catalog and Ordering Instructions
Other Important Documents
See other important documents for both of our OneCare Complete and OneCare Flex Plus plans.
Notice of Availability and Notice of Nondiscrimination
OneCare Member Forms
Forms Related to Your Protected Health Information (PHI)
View forms related to your PHI and medical records as a OneCare member.
Authorization for Release of PHI
Additional Forms Related to Your PHI
Access more forms related to handling your PHI as a OneCare member.
Request for an Accounting of Disclosure
Request for Restriction on Manner/Method of Confidential Communications
Your Rights, Responsibilities and Reporting Fraud, Waste and Abuse as a OneCare Member
Review your rights as a CalOptima Health OneCare member. If you think you see fraud or waste, call our Compliance and Ethics Hotline at 1-855-507-1805 (TTY 711) or complete our fraud, waste and abuse reporting form.
CalOptima Health OneCare Member Rights and Responsibilities
How to Report and Solve Problems
Other OneCare Member Forms
View additional forms for our OneCare members.
Frequently Asked Questions (FAQ)
See More FAQsWhat is Medicare Advantage?
Medicare Advantage combines Medicare Part A (hospital), Medicare Part B (medical) and Part D (prescription drugs) into one plan. This is also known as Part C.What is a D-SNP plan?
A dual-eligible special needs plan (D-SNP) is a type of Medicare Advantage plan for people who get both Medicare and Medi-Cal. Medicare Advantage D-SNP plans, such as CalOptima Health’s OneCare options, are made to meet your your unique needs, so that you get your Medi-Cal and Medicare benefits and services in one place.Do I meet the requirements for OneCare?
You could qualify to be a OneCare member if you:
- Live in Orange County
- Have Medicare Parts A and B
- Have full Medi-Cal with no Share of Cost
- Are age 21 or older
How will OneCare help me?
With OneCare, your Medicare, Medi-Cal and Part D benefits are together in one health plan, making it easier for you to understand and use your benefits. You’ll have support from a Personal Care Coordinator (PCC) who can help you get the services you need. You’ll also have access to certain home and community services to help you live safely at home.Can I still see my regular doctor?
Yes, you can see them if they are part of our growing network of more than 7,000 doctors. If your doctor is not in the network, you can keep seeing them for a period of time if they agree to work with OneCare.How much does OneCare cost?
You can enroll in our OneCare options at no cost. You don’t pay plan premiums or deductibles, copays or coinsurance for medical services. However, you might have Standard Part D copays for medicines with OneCare Flex Plus. Call us at 1-877-412-2734 (TTY 711) to learn more.Does OneCare cover transportation?
Yes, you’ll have unlimited trips at no cost to and from your doctor visits. You can also get non-medical transportation, including to the gym and grocery stores, depending on the OneCare option you choose.
Access Helpful Resources
Find a Doctor Near You
Search our network to find a trusted provider that meets your health care needs.
Explore OneCare Benefits
See the benefits and services our OneCare program offers.
Learn About Advance Care Planning
Understand how advance care planning helps you make informed decisions about your health care.
Discover Our Pharmacy Benefit
Read about our pharmacy benefit for info on our covered medicines and services.
See Our Medication Therapy Management (MTM) Program
Access the tools you need to get the most from your medicines