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2021 Benefits & Copays

Santa Clara Family Health Plan Cal MediConnect Plan (Medicare-Medicaid Plan) (SCFHP Cal MediConnect) coordinates all of your Medicare and Medi-Cal benefits under one health plan, including:

  • Medical care
  • Prescription medications, including Part D prescription coverage
  • Behavioral health care
  • Long-term services and supports (LTSS)

You can find a description of the 2021 benefits and copays in the sections below.

For more information, call SCFHP Cal MediConnect Customer Service or read the SCFHP Cal MediConnect Member Handbook and Summary of Benefits.

2021 Annual Notice of Changes (ANOC)

2021 Member Handbook (EOC)

2021 Summary of Benefits

2021 Provider and Pharmacy Directory

2021 List of Covered Drugs (Formulary)

2021 List of Durable Medical Equipment (DME)

Prior Authorization Requirements
Step Therapy Requirements
Language Assistance Services
Nondiscrimination Notice

Santa Clara Family Health Plan 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.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information call 1-877-723-4795 (TTY: 711) or read the Member Handbook.

Enrollment in Santa Clara Family Health Plan Cal MediConnect Plan (Medicare-Medicaid Plan) (SCFHP Cal MediConnect) depends on contract renewal.

Last updated 10/12/2020

H7890_16035W Accepted