Medi-Cal

اعضای جدید از اینجا آغاز کنند

به CalOptima خوش آمدید

1. Sign up to access your CalOptima Health Medi-Cal 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 (HN) or primary care provider (PCP)
  • Request interpreter services

How to sign up and log in to your CalOptima Health Medi-Cal member portal

To sign up, access your secure online member portal at https://member.caloptima.org/#/user/login

2. Choose a PCP and an HN

A PCP is a health care provider who is responsible for your routine medical care. A health network is a group of doctors and hospitals that provide your health care services.

You must choose a PCP and HN from the Provider Directory within 30 days of enrolling in CalOptima Health. If you don’t choose an HN after 30 days of becoming a member, CalOptima Health will choose one for you. You may change your PCP and HN every 30 days.

How to find a PCP and HN:

  • If you have a doctor you want to keep or want to find a new PCP, go to the online Provider Directory at www.caloptima.org/en/ForMembers/Medi-Cal/FindAProvider. The Provider Directory has information to help you choose a PCP.
  • If you need a Provider Directory mailed to you, call CalOptima Health Customer Service at 1-714-246-8500 or toll-free at 1-888-587-8088 (TTY 711), Monday through Friday, from 8 a.m. to 5:30 p.m. We have staff who speak your language.

How to choose a PCP and HN:

To select your PCP and HN, you can:

  • Access your secure online member portal at https://member.caloptima.org/#/user/login , or
  • Call CalOptima Health Customer Service at 1-714-246-8500 or toll-free at 1-888-587-8088 (TTY 711), or
  • Complete and return the CalOptima Health Network Selection Form sent in your new member packet.

3. Learn about your Medi-Cal benefits

The Member Handbook tells you about your coverage under CalOptima Health. Please read it carefully and completely. It will help you understand the benefits and services available to you and how to get the care you need. It also explains your rights and responsibilities as a CalOptima Health member.

  • To get a complete list of services we cover, view the Member Handbook at https://www.caloptima.org/en/ForMembers/Medi-Cal/Benefits.
  • If you want a Member Handbook mailed to you or have benefit questions, please call CalOptima Health Customer Service at 1-714 246-8500 or toll-free at 1-888-587-8088 (TTY 711).

4. Schedule your Initial Health Appointment (IHA)

CalOptima Health recommends scheduling your first visit with your new PCP within 120 days for an IHA. The IHA 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 Medi-Cal

See your doctor as soon as you think you are pregnant to begin 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 Medi-Cal

Depending on your situation, you may qualify for either medical transportation or non-medical transportation. These services are not for emergencies and may be free.

Medical Transportation

You can get medical transportation if you have medical needs that don’t allow you to use a car, bus or taxi to your appointments. You can get medical transportation by ambulance, litter van, wheelchair van or air transport for covered services and Medi-Cal-covered pharmacy appointments. You can request medical transportation by asking your doctor, dentist, podiatrist or mental health or substance use disorder provider for it. Your provider will decide the correct type of transportation to meet your needs.

You can get non-medical transportation to your appointments when the appointment is for a Medi-Cal-covered service, and you don’t have access to transportation. CalOptima Health allows you to use a car, taxi, bus or other public or private way to get to your medical appointment for Medi-Cal-covered services. You can get a ride for free when you have tried all other ways to get transportation.

What is the CalOptima Health Medi-Cal transportation phone number?
To request a ride for authorized services, call CalOptima Health’s transportation line at 1-833-648-7528 (TTY 711) at least 2 business days (Monday–Friday) before your appointment. Or call as soon as you can when you have an urgent appointment. Have your member ID card ready when you call.

If you need Medi-Cal dental services

The Medi-Cal Dental Fee for Service (FFS) Program is the same as FFS Medi-Cal for your dental services. Before you get dental services, you must show your state-issued Medi-Cal Benefits Identification Card (BIC) to the dental provider. Make sure the provider takes FFS Dental and you are not part of a managed care plan that covers dental services. Medi-Cal covers many different dental services through the Medi-Cal Dental Program.

If you have questions about Medi-Cal dental services, call the Medi‑Cal Dental Program at 1-800-322-6384 (TTY 1-800-735-2922 or 711). You can also visit the website at https://www.dental.dhcs.ca.gov or https://smilecalifornia.org/.

If you need Medi-Cal vision services

Medi-Cal vision coverage includes:

  • Routine eye exam once every 24 months; more frequent eye exams are covered if medically necessary for members, such as those with diabetes
  • Eyeglasses (frames and lenses) once every 24 months with a valid prescription

For more information, call Vision Service Plan (VSP) at 1-800-438-4560 (TTY 1-800-735-2922) or go to https://www.vsp.com/. You can also use our provider search tool at https://www.caloptima.org/en/ForMembers/Medi-Cal/FindAProvider to help you find a Medi-Cal vision provider.

Frequently Asked Questions

What is my CalOptima Health Medi-Cal login?

You can sign up or reset your password to the CalOptima Health Medi Cal member portal by visiting https://member.caloptima.org/#/user/login.

Do I need my Medi-Cal card for an appointment?

Yes. For medical appointments, use your CalOptima Health Medi-Cal member ID card. For other services such as dental, vision and pharmacy, use your state-issued Medi-Cal BIC.

How do I replace my Medi-Cal card?

If your CalOptima Health member ID card is damaged, lost or stolen, call CalOptima Health Customer Service right away at 1-714-246-8500 or toll-free at 1-888-587-8088 (TTY 711). CalOptima Health will send you a new card for free. You can also request an ID card or print a copy on the CalOptima Health Medi Cal member portal by visiting https://member.caloptima.org/#/user/login.
If your Medi-Cal BIC is damaged, lost or stolen, call the County of Orange Social Services Agency at 1-800-281-9799.

How do I check my Medi-Cal benefits?

You can check your Medi-Cal benefits in the CalOptima Health Medi-Cal Member Handbook at https://www.caloptima.org/en/ForMembers/Medi-Cal/Benefits, by visiting the CalOptima Health Medi-Cal member portal or by calling Customer Service at 1-714 246-8500 or toll-free at 1-888-587-8088 (TTY 711).

How do I make a doctor’s appointment if I have Medi-Cal?

After choosing your PCP, call their office directly to schedule appointments. If you need help, call CalOptima Health Customer Service at 1-714-246-8500 or toll-free at 1-888-587-8088 (TTY 711).

Does Medi-Cal cover vision?

Yes, Medi-Cal covers vision services. You can learn more about your Medi-Cal vision benefits and how to access them in your Member Handbook at https://www.caloptima.org/en/ForMembers/Medi-Cal/Benefits or by calling Customer Service at 1-714-246-8500 or toll free at 1-888-587-8088 (TTY 711).

برای اعضای جدید CalOptima، یک بسته «به CalOptima خوش آمدید» از طریق پست ارسال می‌شود. این بسته را در اولین فرصت باز کنید و این 4 کار را انجام دهید:

1. انتخاب یک ارائه‌دهنده اولیه خدمات درمانی (PCP) و یک شبکه درمانی

در این بسته دستورالعمل‌هایی پیرامون نحوه دسترسی به شبکه درمانی و فهرست ارائه‌کنندگان وجود دارد. لطفاً یک پزشک مراقبت‌های درمانی اصلی و یک شبکه درمانی از این فهرست انتخاب کنید. همچنین باید یک پزشک مراقبت‌های درمانی اصلی انتخاب کنید که متعلق به شبکه درمانی منتخب‌تان باشد.

2. پر کردن فرم انتخاب شبکه درمانی

فرم انتخاب شبکه درمانی در داخل بسته ویژه عضو جدید است. باید نام شبکه درمانی و ارائه‌دهنده مراقبت‌های اولیه مورد انتخاب خود را بنویسید، فرم را امضا کنید و آن را در اسرع وقت به CalOptima بازگردانید.

3. خواندن کتابچه راهنمای اعضای CalOptima و نگه داشتن آن

در این بسته دستورالعمل‌هایی پیرامون نحوه دسترسی به دفترچه اطلاعاتی اعضای CalOptima وجود دارد. دفترچه شما حاوی اطلاعات مهمی درباره برنامه‌ها و خدمات CalOptima است. برای مشاهده موارد تحت پوشش ما، چگونگی تغییر شبکه‌ درمانی، چگونگی تغییر پزشک مراقبت‌های درمانی اصلی و بسیاری از جزئیات دیگر، به دفترچه راهنمایتان مراجعه کنید.

4. برنامه ریزی اولین معاینه پزشکی

اولین معاینه پزشکی خود را ظرف 90 روز (3 ماه) از تاریخ پیوستن به CalOptima برنامه ریزی کنید. ما معتقدیم، مراقبت پیشگیرانه بهترین روش حفظ سلامت شما و خانواده‌تان است. این به معنای اولین مراجعه به پزشک‌تان است، حتی اگر بیمار نیستید. پزشک شما می‌تواند مسائل پزشکی را پیش از تبدیل شدن به مشکلات بزرگ تشخیص دهد.

باردار هستید؟

کارهایی که باید پیش از اقدام به باردار شدن انجام دهید

شبکه درمانی شما یا CalOptima، خدمات تنظیم خانواده را پوشش می‌دهد. این موارد شامل مشاوره، آزمایش بارداری و روش‌های پیشگیری از بارداری است. با شماره‌های زیر با بخش خدمات مشتریان CalOptima تماس بگیرید.

کارهایی که باید در دوره بارداری انجام دهید

به محض آگاه شدن از بارداری، باید برای دریافت مراقبت پیش از زایمان به پزشک‌تان مراجعه کنید. از پزشک‌تان درباره خدمات پشتیبانی مراقبت‌های دوران بارداری بپرسید. این برنامه اطلاعات بیشتری در دوره بارداری و تا دو ماه پس از به دنیا آمدن نوزاد در اختیارتان قرار می‌دهد.

تماس با ما
اعضاء جدید مدیکل (Medi-Cal)
داروخانه
فرمها و اطلاعات