HOW TO ENROLL
CALL SCFHP
Monday through Friday
8 a.m. to 8 p.m.
1-888-202-3353
TTY/TDD 1-800-735-2929 or 711
If you have both Medicare and Medi-Cal, you have a health plan option called Cal MediConnect. As a member of Santa Clara Family Health Plan Cal MediConnect Plan (Medicare-Medicaid Plan) you get:
SCFHP received the National Committee for Quality Assurance (NCQA) Accreditation status of Accredited for our Cal MediConnect (Medicare-Medicaid Plan) line of business. Meaning we provided our members quality services that meet NCQA’s strict standards! Read more about NCQA accreditation and what it means for our members.
We want to make sure you get the most out of your Cal MediConnect Plan. Here are videos to help you understand the plan.
Quý vị có biết tiếng Việt không? Những video này giải thích Cal MediConnect bằng tiếng Việt.
CALL SCFHP
Monday through Friday
8 a.m. to 8 p.m.
1-888-202-3353
TTY/TDD 1-800-735-2929 or 711
CALL HEALTH CARE OPTIONS (HCO)
Monday through Friday
8:00 a.m. to 5:00 p.m.
1-844-580-7272
TTY/TDD 1-800-430-7077
Member Handbook [11]
Provider and Pharmacy Directory [12]
List of Covered Drugs (Formulary) [13]
Summary of Benefits [14]
Notice of Nondiscrimination/ Language Assistance [15]
Getting Started [16]
Member Materials [17]
Helpful Information [18]
Frequently Asked Questions [19]
National Coverage Determinations [20]
Health Education [21]
Notice of Privacy Practices [22]
Report Fraud [23]
List of Covered Drugs (Formulary) [13]
Step Therapy Requirements [24]
Prior Authorization Requirements [25]
Find a Pharmacy [26]
Mail Order [27]
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 contact the plan or read the Member Handbook.
Enrollment in Santa Clara Family Health Plan Cal MediConnect Plan (Medicare-Medicaid Plan) depends on contract renewal. CMS (the Centers for Medicare & Medicaid Services) must approve SCFHP Cal MediConnect each year. You can continue to get health coverage as a member of our plan only as long as we continue to offer the SCFHP Cal MediConnect Plan for the year in question and CMS renews its approval of the plan. Even if SCFHP leaves the program, you will not lose health coverage. If SCFHP decides not to continue for the next calendar year, we must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Last updated 04/19/2019
H7890_14095W201812 Accepted
Links
[1] https://www.healthcareoptions.dhcs.ca.gov/enroll
[2] https://www.scfhp.com/healthcareplans/calmediconnect/how-enroll
[3] https://www.scfhp.com/healthcareplans/calmediconnect/how-disenroll
[4] https://www.scfhp.com/healthcare-plans/calmediconnect/2019-benefits-copays
[5] https://www.scfhp.com/healthcareplans/calmediconnect/pharmacy-benefits-services
[6] https://www.scfhp.com/healthcareplans/calmediconnect/medication-therapy-management
[7] https://www.scfhp.com/healthcareplans/calmediconnect/how-choose-see-provider
[8] http://www.scfhp.com/for-members/find-a-doctor
[9] https://www.scfhp.com/healthcareplans/calmediconnect/care-coordination
[10] https://www.scfhp.com/healthcareplans/calmediconnect/appeals-grievances
[11] https://www.scfhp.com/sites/default/files/cmcmemberhandbook_en.pdf
[12] https://www.scfhp.com/sites/default/files/cmcdirectory_en.pdf
[13] https://www.scfhp.com/sites/default/files/cmcformulary_en.pdf
[14] https://www.scfhp.com/sites/default/files/cmcsummarybenefits_en.pdf
[15] https://www.scfhp.com/sites/default/files/Nondiscrimination_Language_Assistance.pdf
[16] http://www.scfhp.com/getting-started
[17] https://www.scfhp.com/healthcareplans/calmediconnect/member-materials
[18] https://www.scfhp.com/healthcareplans/calmediconnect/cal-mediconnect-helpful-information
[19] https://www.scfhp.com/healthcareplans/calmediconnect/cal-mediconnect-frequently-asked-questions
[20] http://www.scfhp.com/healthcare-plans/calmediconnect/national-coverage-determinations
[21] https://www.scfhp.com/for-members/health-education
[22] https://www.scfhp.com/for-members/helpful-information/notice-of-privacy-practices
[23] http://www.scfhp.com/healthcareplans/calmediconnect/report-fraud
[24] https://www.scfhp.com/sites/default/files/2019cmcsteptherapy.pdf
[25] https://www.scfhp.com/sites/default/files/2019priorauth.pdf
[26] https://bit.ly/2J8SbUf
[27] https://www.medimpactdirect.com
[28] https://www.scfhp.com/mtm