New 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. Follow these steps to get started:

CalOptima Health’s website makes it easier for you to find what you need using any device. A secure online member portal lets you:

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.

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.

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.

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.

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.

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:

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. uses a transportation vendor to arrange non-medical transportation. We cover the lowest-cost, non-medical transportation type that meets your needs.

To ask for a ride for authorized services, call 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.

Certain dental services are available through the Medi-Cal Dental Program.

OneCare vision coverage includes:

Yes. For most services, like medical appointments, vision and pharmacy services, use your CalOptima Health OneCare Member ID Card. For dental services, use your state-issued Medi-Cal Benefits Identification Card (BIC).

After choosing your PCP, you can call their office directly to schedule appointments. If you need help, call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711).