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2022 Benefits & Copays

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

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

You can find a description of the 2022 benefits and copays in the sections below.

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

2022 Annual Notice of Changes (ANOC)

2022 Member Handbook (EOC)

2022 Summary of Benefits

2022 Provider and Pharmacy Directory

2022 List of Covered Drugs (Formulary)

2022 List of Durable Medical Equipment (DME)

Prior Authorization Requirements
Step Therapy Requirements
Language Assistance Services
Nondiscrimination Notice



You can ask for published materials for free in other formats, such as large print, Braille, or audio. Call SCFHP Cal MediConnect Plan Customer Service for help.

If you are more comfortable speaking a language other than English, Santa Clara Family Health Plan can help you. Whether you are contacting SCFHP or visiting a doctor, we have interpreters available. Tell your doctor you would like an interpreter for your visit.

Know your rights

  • You can get an in-person or telephone interpreter at no cost to you. This includes American Sign Language.
  • When you go to the doctor, interpreters are available 24-hours a day.
  • You can ask for SCFHP Cal MediConnect Plan materials in English, Spanish, Simplified Chinese, Tagalog, and Vietnamese.

How can you get an interpreter?

Tell your doctor’s office you would like one. You can do this when you call to set up your next visit. You can also ask us for an interpreter or for translated materials.

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 10/01/2021

H7890_17023W Accepted