Contact: Cristina Hernandez
During this year’s Medicare Open Enrollment period, Santa Clara Family Health Plan (SCFHP) is launching SCFHP DualConnect (HMO D-SNP), a dual eligible special needs plan (D-SNP). Starting October 15, 2022, eligible Santa Clara county residents can enroll in the integrated plan that combines their Medi-Cal and Medicare benefits (acute, primary, institutional, and home and community-based services) under a single plan to make managing health care easier. SCFHP’s currently enrolled 10,480 Cal MediConnect members will also transition into DualConnect. Coverage for both newly enrolled SCFHP members and transitioning Cal MediConnect members will start January 1, 2023.
The transition from the Cal MediConnect demonstration project to a dual eligible special needs plan is part of the California Department of Health Care Service’s California Advancing and Innovating Medi-Cal (CalAIM) initiative and will expand the care coordination and integration that dual eligible beneficiaries received with Cal MediConnect. SCFHP DualConnect will align care for members by meeting integrated D-SNP care coordination requirements, simplifying complex member materials, and limiting membership to dually eligible individuals who are also enrolled in SCFHP’s Medi-Cal plan.
“Managing one’s health is not easy, especially when juggling multiple government benefit programs,” said Thien Ly, Director of Medicare Outreach. “With SCFHP DualConnect, we aim to continue supporting our members by offering the seamless care coordination they received with Cal MediConnect and welcome all new members who would benefit from the support of our local staff and provider network.”
With SCFHP DualConnect, members receive:
• A choice of hundreds of primary care doctors.
• Access to most area hospitals.
• Access to thousands of specialists.
• A care coordinator and an Individualized Care Plan to help you reach your health care goals.
• $0 copay for prescription drugs.
• Up to $135 for over-the-counter (OTC) items every three months.
• $0 fitness membership at YMCA of Silicon Valley locations.
• Prescriptions available at most national chains and at independent pharmacies in Santa Clara County.
• A 24-hour nurse advice line.
• Resource navigation, health, and wellness classes, and in-person support at the SCFHP Blanca Alvarado Community Resource Center in East San José.
• Bilingual staff who speak Spanish and Vietnamese plus interpreter services in any language at no cost.
For questions about enrollment, visit www.scfhp.com/dualconnect or call 1-888-202-3353 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m.
About Santa Clara Family Health Plan
Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to creating opportunities for better health and wellness for all. In partnership with providers and community organizations since 1997, we work to ensure everyone in Santa Clara County has access to equitable, high-quality health care. With a strong commitment to integrity, outstanding service, and support for our community, we serve more than 315,000 people through our Medi-Cal and Cal MediConnect health care plans. For more information, visit www.scfhp.com.