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Let SCFHP DualConnect make it easy for you.

Healthcare can be confusing when you're trying to juggle multiple government agencies and identification cards – all with different sets of numbers and rules. Santa Clara Family Health Plan (SCFHP) DualConnect is a Medicare Medi-Cal Plan designed to help you.

The Annual Election Period for those with Medicare ended December 7, 2022.

You can still join if you are newly eligible for Medicare or have a qualifying event. Learn more about Options for Joining Outside the Annual Election Period – see information on this page.

You can also call SCFHP to ask questions or to confirm eligibility at 1-888-202-3353 (TTY:711), Monday through Friday, 8 a.m. to 5 p.m.

What is SCFHP DualConnect?

SCFHP now offers DualConnect, a Dual Eligible Special Needs Plan (HMO D-SNP), for individuals who are entitled to both Medicare and Medi-Cal. SCFHP DualConnect coordinates all your Medicare and Medi-Cal benefits – and even Medicare Part D drug benefits – so you don’t have to do the juggling. With SCFHP DualConnect, you get healthcare tailored just for you. Simple. Easy. Personal.

If you’re unfamiliar with the term D-SNP (also commonly known as DSNP or DSNPs), it is a special needs Medicare Advantage plan for people who are "dual-eligible" – meaning they qualify for both Medicare and Medi-Cal. We can make it even easier to understand: a D-SNP is a simple way to manage all your healthcare plans under one single umbrella – and we can set it all up for you. When you’re looking for a Medicare plan that’s right for you, just ask for SCFHP DualConnect.

One Plan. So Many Advantages.

For all your healthcare needs.

Sample ID cardWith SCFHP DualConnect, there's only one plan to keep track of, and we'll help coordinate your care between your doctor's office, hospital or pharmacy.

A care team and personal care coordinator just for you.

We make healthcare easy and friendly. Your SCFHP personal care coordinator works closely with your primary care provider and other members of your care team. Together with you, they develop your Individualized Care Plan that helps you meet your health care goals. Your coordinator can help you:

  • Understand your specific healthcare concerns
  • Coordinate care and services among the physical, behavioral, dental, and social services delivery systems
  • Schedule your preventive screenings and other tests
  • Direct you to other helpful services within SCFHP and in the community

Benefits and Copays

For more information about benefits and copays, click here.

One of the largest provider networks in Santa Clara County.

Our plan gives you access to hundreds of providers and specialists, as well as access to most area hospitals.

Bilingual customer service team plus interpreter services in any language – at no cost.

Our bilingual staff speaks Spanish and Vietnamese, and we offer interpreter services in all languages at no cost to you. If you need help in your language, call 1-877-723-4795 (TTY: 711). Aids and services for people with disabilities, like documents in braille and large print, are also available. Call 1-877-723-4795 (TTY: 711)

SCFHP also offers bilingual in-person support and no-cost health education workshops at the SCFHP Blanca Alvarado Community Resource Center (CRC) in East San José.

The Zeros Add Up

We make healthcare easy and affordable. With SCFHP DualConnect, you pay $0 for covered healthcare services, prescription drugs, and other benefits. Plus, you get many value-added services. Our SCFHP DualConnect plan features:

  • $0 monthly premium
  • $0 copay for doctor visits
  • $0 copay for prescription drugs
  • $0 copay for hospitalization
  • $0 fitness membership at YMCA of Silicon Valley
  • $0 for unlimited transportation to plan-approved locations

How to Join

The Annual Election Period for 2022 with coverage to begin on January 1, 2023, is over.

However, you may still be able to ENROLL NOW if this is your first time enrolling in Medicare (Initial Enrollment Period) or you have a “qualifying event” that entitles you to a Special Enrollment Period. See options below for more information.

Cal MediConnect Members: Existing SCFHP Cal MediConnect plan members will transition to the new SCFHP DualConnect plan effective January 1, 2023, with no gap in Medi-Cal, Medicare, and Medicare Part D prescription drug benefits. If you have any questions about our new DualConnect plan or these changes, please call us at 1-877-723-4795 (TTY:711), 7 days a week, 8 a.m. to 8 p.m.

Options for Joining Outside the Annual Election Period

You may also enroll after the Annual Election Period ends December 7, 2022. You may still enroll if this is your first time enrolling in Medicare (Initial Enrollment Period) or you have a “qualifying event” that entitles you to a Special Enrollment Period. See options below for more information.

Initial Enrollment Period: You can enroll when you first become eligible for Medicare at age 65. You are allowed a seven-month Initial Enrollment Period which includes three months before your birthday month and three months after. For example, if you turn 65 in May, you can enroll three months before, beginning in February, and your enrollment period will end three months after your birthday month in August.

Please Note: You can also qualify for Medicare due to a disability – If you have been receiving Social Security Income or Railroad Retirement Board disability benefits for 24 months, you become eligible for Medicare even if you are not 65. Your initial enrollment period then would include three months before and after the 25th month of your disability.

Special Enrollment Period: You can enroll if you have certain special reasons or a “qualifying event” that entitles you to a Special Enrollment Period, like the following:

  • You have both Medicare and Medicaid, but you haven’t had any changes
  • You recently had a change with Medicaid (newly got Medicaid, had a change in the level of Medicaid)
  • You move outside your current plan’s service area
  • Your plan is ending its contract with Medicare or Medicare is ending its contract with your plan
  • Nursing home residency (whether you are moving in, moving out or living in one)
  • You are released from jail and qualify for both Medicaid and Medicare
  • Your employment ends and you lose “creditable group health insurance”

Need assistance?

If you have questions or need additional assistance, contact us today! Our local Medicare Outreach team is here to help answer your questions and give you the information you need.

For questions about enrollment:

1-888-202-3353 (TTY: 711)
Monday through Friday, 8 a.m. to 5 p.m.
Email: MedicareOutreach@scfhp.com
Website: scfhp.com/enroll

For Customer Service:

1-877-723-4795 (TTY: 711)
7 days a week, 8 a.m. to 8 p.m.
Email: ContactDualConnect@scfhp.com
Website: www.scfhp.com

For in-person assistance:

Visit us at the SCFHP Blanca Alvarado Community Resource Center
408 N Capitol Avenue
San Jose, CA 95133
Phone: 1-408-874-1750
Monday through Friday,
10 a.m. to 12 p.m. and 1 p.m. to 5 p.m.
Website: crc.scfhp.com

Enrollees must live in Santa Clara County, be 21 years or older, have both Medicare A and B, and have full scope Medi-Cal to be eligible for SCFHP DualConnect.

Santa Clara Family Health Plan DualConnect is an HMO D-SNP with a Medicare and Medi-Cal contract. Enrollment in DualConnect depends on contract renewal.

Last updated: December 8, 2022

H4045_23013W Accepted