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DualConnect

If you have both Medicare and Medi-Cal, you have a health plan option called DualConnect. As a member of Santa Clara Family Health Plan DualConnect (HMO D-SNP) (SCFHP DualConnect), a Medicare Medi-Cal Plan, you get:

  • No monthly premium for all of your Medicare and Medi-Cal benefits in one health plan, including access to doctors and hospitals
  • $0 copay for doctor visits
  • $0 copay for prescription drugs
  • $0 copay for hospitalization
  • Up to $135 for qualified over-the-counter (OTC) items every three months
  • $0 fitness membership at YMCA of Silicon Valley
  • $200 vision allowance every 2 years
  • $1,510 hearing aids allowance for both ears per fiscal year (July 1 - June 30)
  • Unlimited transportation to plan-approved locations
  • Personal Care Coordinator and Individualized Care Plan
  • Resource navigation and in-person support at the SCFHP Blanca Alvarado Community Resource Center in East San Jose
  • Convenient access to your health plan information in our member portal, mySCFHP
  • One membership card and one phone number to call to get help
  • Behavioral health care
  • Durable medical equipment
  • A 24-hour Nurse Advice Line for help with non-emergency care
  • Long-term services and supports (LTSS), including Community-Based Adult Services (CBAS), and Nursing Facilities (NF)
  • A case manager and a care team. Your case manager can answer your questions, help you find community services, assist you in making your medical appointments, and help you talk to your doctors and other providers
  • An individual care plan (ICP) created to help you reach your health goals.

Frequently asked questions

Who can join SCFHP DualConnect?

Santa Clara County residents with full Medicare (Part A and Part B) and full Medi-Cal benefits may be able to join. You can tell if you have Medicare and/or Medi-Cal by the type of cards you have:

Medicare Card Image
Your Medicare Card


- or -


Your Medi-Cal Card

Why should I join SCFHP DualConnect?

With SCFHP DualConnect Plan, your benefits and services work better together:

  • One plan
  • One member ID card
  • One phone number to call for help

Most importantly, you can get help from a case manager to coordinate your care, especially during transitions—like when you leave the hospital. Your case manager can help you:

  • Understand your health plan benefits
  • Find doctors and specialists within your network
  • Choose or change a doctor
  • Get authorizations for care, equipment, or supplies
  • Get long-term services and supports and help from other community resources
  • Arrange transportation to your medical appointments
  • Schedule health screenings

Read more about case management and care coordination.

How do I enroll?

To enroll, please call:
SCFHP at 1-888-202-3353 (TTY: 711)
Monday through Friday from 8 a.m. to 5 p.m.

What is the Health Insurance Counseling & Advocacy Program (HICAP)?

The Health Insurance Counseling & Advocacy Program (HICAP) gives free health insurance counseling to people with Medicare. HICAP counselors can answer your questions and help you understand what to do to handle your problem. HICAP has trained counselors in every county, and services are free.

HICAP is not connected with any insurance company or health plan.
Call: 1-408-350-3200 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m.

Write:

Sourcewise
3100 De La Cruz Blvd, Suite 310
Santa Clara, CA 95054

Email: community@mysourcewise.com

Website: www.mysourcewise.com

Contact HICAP for questions about SCFHP DualConnect or other Medicare questions. HICAP counselors can answer your questions about changing to a new plan and help you:

  • Understand your rights
  • Understand your plan choices
  • Make complaints about your health care or treatment
  • Straighten out problems with your bills

What is the service area for SCFHP DualConnect?

You must live in Santa Clara County to enroll in SCFHP DualConnect. And you must continue living in Santa Clara County to stay a member of the plan.

How to contact Santa Clara Family Health Plan?

To reach SCFHP DualConnect Customer Service:

Call toll-free: 1-877-723-4795 (TTY: 711)
7 days a week, 8 a.m. to 8 p.m.
We have free interpreter services for people who do not speak English.

Write:

Attn: Customer Service Department
Santa Clara Family Health Plan
PO Box 18880
San Jose, CA 95158

Visit:

SCFHP Blanca Alvarado Community Resource Center
408 N. Capitol Ave
San Jose, CA 95133
Business Hours: 10:00 a.m. to 5:00 p.m., Monday - Friday

Santa Clara Family Health Plan
6201 San Ignacio Ave
San Jose, CA 95119
Business Hours: 8:30 a.m. - 5:00 p.m., Monday - Friday
Customer Service: 1-877-723-4795

How to contact Medicare?

To contact Medicare:

Call:

1-800-MEDICARE (1-800-633-4227). Calls to this number are free, 24 hours a day, 7 days a week. TTY: 1-877-486-2048. This call is free.

Website: www.medicare.gov

What is Medicare?

Medicare is the federal health insurance program for people 65 years of age or older, some people under age 65 with certain disabilities, and people with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).

The federal agency in charge of Medicare is the Centers for Medicare & Medicaid Services, or CMS.

To contact Medicare:

Call: 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week.

TTY: 1-877-486-2048. This number is for people who have hearing or speaking problems. You must have special telephone equipment to call it.

Your call is free.

Website: www.medicare.gov

This is the official website for Medicare. It gives you up-to-date information about Medicare.

How to contact your case manager?

Call SCFHP Case Management at 1-877-590-8999 (TTY: 711), Monday through Friday, 8:30 a.m. to 5 p.m. This call is free.

How to access Health Education?

As an SCFHP DualConnect member, you have access to classes and programs to help you manage your health. Health Education services are designed to support our members in living healthier lives. All classes and programs are provided at no cost to SCFHP DualConnect members. Topics include:

  • Chronic disease management (for asthma, diabetes, high blood pressure, etc.)
  • Counseling and support services
  • Nutrition and weight management
  • Prenatal education
  • Safety
  • Sexual health
  • Smoking cessation

Please visit our Health Education page to see our list of classes and programs. For more information or to sign up for a class, login to the mySCFHP member portal, or call SCFHP DualConnect Customer Service and ask for Health Education at 1-877-723-4795 (TTY: 711), 7 days a week, 8 a.m. to 8 p.m.

What happens if you receive a bill?

You should not get any bills from your provider. If you get a bill, contact us for help at 1-877-723-4795 (TTY: 711), 7 days a week, 8 a.m. to 8 p.m. You can learn more about what to do on our Frequently Asked Questions page.

Notice of Privacy Practices

This notice describes how your medical information may be used and disclosed. This notice also describes how you can get access to this information. Please review it carefully.

Notice of Privacy Practices
Aviso de Prácticas de Privacidad
Thông Báo Về Các Biện Pháp Bảo Vệ Quyền Riêng Tư
隐私条例公告
Paunawa ukol sa Mga Gawi sa Pagkapribado​

If you have questions, please contact SCFHP DualConnect Customer Service at 1-877-723-4795 (TTY: 711), 7 days a week, 8 a.m. to 8 p.m.

Accessibility

You can ask for published materials for free in other formats, such as large print, braille, or audio. Call SCFHP DualConnect Customer Service for help.

If you are more comfortable speaking a language other than English, SCFHP 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 DualConnect materials written in other languages.

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

Last updated 12/27/2022

H4045_23013W Accepted