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CommuniCare Advantage
Cal MediConnect

     Cal MediConnect Home
     Plan Information
     How to Enroll or
     Disenroll

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How to Enroll or Disenroll

Enrolling in CommuniCare Advantage Cal MediConnect Plan is easy. It's simple!

  • Call our Customer Service representatives who will explain the plan and answer your questions at 1-888-244-4430 (TTY 1-855-266-4584). The Customer Service representative will take your information and a Marketing Representative will call you to schedule an appointment to complete the enrollment application form. CommuniCare Advantage Cal MediConnect Plan representatives are available 24 hours a day, 7 days a week, including holidays.
  • To enroll in CommuniCare Advantage Cal MediConnect Plan you can also call Health Care Options, the State Enrollment Broker at 1-844-580-7272 (TTY 1-800-430-7077). Hours of operation: Monday - Friday, 8am - 5pm. www.HealthCareOptions.dhcs.ca.gov

  • If you live in San Diego County and you are receiving Medi-Cal and Medicare benefits, you can sign up for CommuniCare Advantage Cal MediConnect Plan at any time. It's a simple way to combine your Medi-Cal and Medicare benefits into one easy to use health care plan.
    • No premiums or deductibles. You pay zero dollars out of your pocket for doctor's visits, emergency services or hospitalization.
    • Non-emergency transportation for 36 one-way visits to the doctor per year. Worldwide emergency services (excludes transportation back to the U.S.).
Disenrolling from CommuniCare Advantage Cal MediConnect Plan.

Ending your membership in our Plan may be voluntary (your own choice) or involuntary (not your own choice):

  • You might leave our Plan because you have decided that you want to leave.
  • There are also limited situations where we are required to end your membership. For example, if you move permanently out of our geographic service area.

If you leave CommuniCare Advantage Cal MediConnect Plan, it may take time before your membership ends and your new Medicare and Medi-Cal coverage begins. See Page 199 for more information. During this time, you will keep getting your health care and drugs through our plan.

If we end your membership in our Cal MediConnect Plan, we must tell you our reason(s) in writing for ending your membership. We must also explain how you can file a grievance or make a complaint about our decision to end your membership. You can also see Chapter 9, Section 4, Page 148 of the Member Handbook for more information about how to make a complaint.

For full information on CommuniCare Advantage Cal MediConnect Plan benfits, please call our Customer Service department at 1-888-244-4430 (TTY 1-855-266-4584). CommuniCare Advantage Cal MediConnect Plan representatives are available 24 hours a day, 7 days a week, including holidays.

You have the right to leave our Cal MediConnect plan at any time

No one can make you stay in our plan if you do not want to. You can leave our plan at any time. If you leave our plan, you will still be in the Medicare and Medi-Cal programs. You have the right to get most of your health care services through Original Medicare or a Medicare Advantage plan. You can get your Medicare Part D prescription drug benefits from a prescription drug plan or from a Medicare Advantage plan. Your Medi-Cal benefits will continue to be offered through Community Health Group unless you choose a different plan available in this county.

If you decide to end your membership, tell Medicare or Medi-Cal that you want to leave CommuniCare Advantage Cal MediConnect Plan:

  • Call Health Care Options at 1-844-580-7272, Monday through Friday, from 8:00 a.m. to 5:00 p.m. TTY users should call 1-800-430-7077; OR
  • Call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users (people who are deaf, hard of hearing, or speech disabled) should call 1-877-486-2048. When you call 1-800-MEDICARE, you can also enroll in another Medicare health or drug plan.

Please see Chapter 10, Section A, page 193 of the Member Handbook for more information on leaving our plan.

If you have questions, please call CommuniCare Advantage Cal MediConnect Plan at 1-888-244-4430, 24 hours a day, 7 days a week. The call is free.



How To Change To A Different Plan

If you decide to leave CommuniCare Advantage Cal MediConnect Plan, you can switch to a different plan or to original Medicare (either with or without a separate Medicare prescription drug plan).

If you want to change to a different plan, there are many choices. Medicare Advantage plans AND/OR Medicare prescription drug plans are available as well as the plan you are now enrolled in .These other plans may differ in coverage, monthly premiums, and cost sharing amounts.

Beneficiaries who are eligible to join Community Health Group's CommuniCare Advantage Cal MediConnect Plan may enroll or disenroll at any time.

How do you make a change?

If you want to keep getting your Medicare and Medi-Call benefits together from a single plan, you can join a different Cal MediConnect plan.

To enroll in a differnt Cal MediConnect plan:

  • Call Health Care Options at 1-844-580-7272, Monday through Friday from 8:00 a.m. to 5:00 p.m. TTY users should call 1-800-430-7077. Tell them you want to leave Communicare Advantage Cal MediConnect plan and join a different Cal MediConnect plan. If you are not sure what plan you want to join, they can tell you about other plans in your area.

Your coverage with CommuniCare Advantage Cal MediConnect plan will end the last day of the month that we get your request.

If you need information about how to choose or change plans, please refer to your Member Handbook, Chapter 10, Section A, page 198 for more information. This Chapter tells what you need to do. You can also call the Customer Service department at 1-888-244-4430 for assistance.


Disclaimers

CommuniCare Advantage Cal MediConnect Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Enrollment in CommuniCare Advantage Cal MediConnect Plan depends on contract renewal.

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.

Limitations, copays and restrictions may apply. For more information, call CommuniCare Advantage Cal MediConnect Customer Service or read the CommuniCare Advantage Cal MediConnect Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change on January 1 of each year.

Copays for prescription drugs may vary based on the level of Extra Help you receive. Please contact the plan for more details.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-244-4430 (TTY: 1-855-266-4584).

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-244-4430 (TTY: 1-855-266-4584).

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-244-4430 (TTY: 1-855-266-4584).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-244-4430 (TTY: 1-855-266-4584).

ملحوظة:(1-855-266-4584) إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (1-888-244-4430) رقم هاتف الصم والبكم ).

Last update February 28, 2017
H5172_Website2017 Approved 1/17/17