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Msnewsletter 201809 E.Pdf SEPTEMBER 2018 Volume 24, Issue 3 HEALTHY A newsletter for the members of Central California Alliance for Health YOU AND YOUR HEALTH are important to us. Please call us at 1-800- 700-3874 (TTY: 1-800- 735-2929 or 7-1-1) if you have questions, need help or have concerns about your care as an Alliance member. We’re here to help! Service with a smile! Have you ever wondered who is on the ● Answer questions about your ● Send you a new Alliance ID card if other end of the phone when you call benefits you lose yours Member Services? ● Explain how you can get medical ● Assist you with concerns or Our representatives are caring, care and services complaints dedicated professionals. They are here ● Let you know which doctors and We have representatives in Santa to answer your calls Monday through clinics you can go to Cruz, Monterey and Merced counties. Friday from 8 a.m. to 5:30 p.m. ● Help you choose or change your They live and work in the communities Our representatives are ready to: Primary Care Provider we serve. What they have in common ● Help you understand how your ● Offer interpreter services if you do is that they care about our members health plan works not speak English, Spanish or Hmong and are here to help. Important notice Member Services will not be available on the following dates and times due to companywide or departmental meetings: ● November 7, all day Permit No. 1186 No. Permit ● CA Merced, December 13, from 10:45 a.m. 95066 CA Valley, Scotts PAID 1600 Green Hills Road, Suite 101 Suite Road, Hills Green 1600 U.S. Postage U.S. to 3:45 p.m. Health for Alliance California Central Standard Mental health services: ● Medi-Cal. Members can access outpatient mental Your health services through Beacon Health Options (Beacon). To find more benefits: information or to find a provider near you, call Beacon at 1-855-765-9700 or visit its website at Did you beaconhealthoptions.com/ members/login. Inpatient and specialty mental health know? services for Medi-Cal members are covered through your county’s Mental Health Department. If you’re not Member benefits to 20 visits per benefit year those who are in a skilled or sure what type of care you Acupuncture and (July 1 through June 30) intermediate care nursing need, you can call Beacon, chiropractic services: for each service. There is a facility. To learn more about and they can help determine ● Medi-Cal. Members can copayment of $10 per visit. your vision benefits or to that and connect you with get a total of two services You will need a referral from find a provider near you, call the right type of care. per calendar month. For your Primary Care Provider Vision Services Plan (VSP) at The numbers to call for example, you can get one to get these services, and 1-800-438-4560. The online the county Mental Health acupuncture visit and one you must go to a contracted VSP Provider Directory can Departments are: chiropractic visit within a provider in our service area. be found at https://provider X Santa Cruz County: month or you can choose to For more information or .portal.ccah-alliance.org/ 1-800-952-2335 get two chiropractic visits to find a provider near you, providerdirectory/. X Monterey County: within a month. No referral is call Member Services or visit ● IHSS. Routine eye exams 1-888-258-6029 required, but you must go to www.ccah-alliance.org. and glasses are not covered X Merced County: a contracted provider in our benefits. There are some 1-888-334-0163 service area. If your provider Routine vision care: medical vision services that ● IHSS. Members can access feels you may benefit from ● Medi-Cal. Members are benefits, such as specialty both inpatient and outpatient having more acupuncture can get an eye exam every care from an ophthalmologist. mental health services through visits for pain management, 24 months. Eyeglasses are For more information, please Beacon. Members can call he or she may send us an a covered benefit only for see your IHSS Evidence of Beacon at 1-800-808-5796 authorization request. members under age 21, Coverage, look on our website or visit beaconhealthoptions ● IHSS. Members can get up those who are pregnant, and or call Member Services. .com/members/login. Medi-Cal services covered by the state (not the Alliance) Did you know that Medi-Cal offers comprehensive For more information or to find a dentist near you, dental benefits to both children and adults? The services call Denti-Cal at 1-800-322-6384, Monday through are provided through the Denti-Cal Program, not Friday, 8 a.m. to 5 p.m. (Pacific Standard Time) or visit through the Alliance. its website at www.denti-cal.ca.gov. 2 HEALTHY CCS services under Whole Child Model Program The Alliance knows that California Children’s Services (CCS) families have created strong relationships with County CCS Program staff over the years. That is why we are working very closely with each County’s CCS Program to understand you and your child’s needs and to continue coordinating your child’s services without interruptions or delays. Here are some of the most frequently asked questions from our CCS families: Is my child still able to: Do I still need to renew my Who can I call when I have a Q. X See their Primary Care Q. child’s CCS eligibility every Q. problem with CCS care, Provider (PCP)? year, and who can help with that? questions or any concerns? X See their specialists? X Get care at Valley Children’s, Yes, the County CCS Program staff The Alliance has Case Management Stanford Children’s, Lucile A. will continue to help complete the A. staff who can help answer questions Packard or another children’s annual eligibility for CCS. Members or concerns about your child’s care. hospital provider? will need to be both Alliance Medi-Cal A Case Manager will help coordinate members and enrolled in the CCS your child’s care and is your go-to Yes, your child is able to see their Program. person. If you don’t know who your A. existing PCP and specialist, as Case Manager is, call the Alliance long as the provider agrees to continue Who can I call if I have a problem Care Management Pediatric Line at seeing your child and is willing to Q. with my Medi-Cal eligibility? 1-800-700-3874, ext. 5513. work with the Alliance. The Alliance is honoring authorizations You should call your local County in place before the transition date A. Medi-Cal office. If your child (July 1). receives Supplemental Security Income (SSI), you should call the Social We are here TO HELP! Is my child able to get: Security Administration office. Q. X Their medication? ● Member Services: X Their specialty medication? Are transportation services 1-800-700-3874 Q. available for my child’s ● Care Management Yes, existing prescriptions are appointments? Pediatric Line: 1-800-700-3874, ext. 5513 A. being filled at your regular pharmacy. Yes, the Alliance can assist with ● Transportation: 1-800-700-3874, ext. 5577 Existing prescriptions for specialty A. transportation services if your medications are being filled by an child has a medical appointment or if ● Language Assistance: 1-800-700-3874 Alliance specialty pharmacy, called you need to pick up a prescription or Diplomat. We worked with your supplies. Prior authorization is required. ● For the Hearing or Speech Assistance Line: specialty pharmacy to transition your Call the Transportation Coordinators’ 1-800-735-2929 1-800-700-3874, ext. 5577, medications to Diplomat. There line at at (TTY: Dial 7-1-1) should be no interruptions to existing least 5 to 7 business days before the ● Website: www.ccah-alliance.org prescriptions. appointment or service date. HEALTHY 3 FluMist for the 2018–2019 flu season FluMist is a nasal influenza vaccine. This vaccine was not on the list of recommended influenza vaccines for the past two years because it did not protect people against the strains of influenza going around in the United States. However, the Centers for Disease Control and Prevention (CDC) has voted to include FluMist in the list of recommended vaccines for children 2 to 4 years of age and for people 49 years or older for the 2018–2019 flu season. Children 2 to 4 years may need up to two doses of the vaccine. The flu season is during the winter months, but it is best to get the vaccine before the flu begins spreading in your community. Children that need two doses New shingles vaccine should start as soon as the vaccine is available, because the doses Shingrix® is a new vaccine approved the two-dose series to help prevent must be given at least four weeks by the U.S. Food and Drug shingles. The immune system gets apart. It takes about two weeks Administration to prevent the weaker as people age; this means after a person gets the vaccine for shingles virus (herpes zoster) for your risk of getting the shingles antibodies to start working in the people 50 and older. virus is greater. Shingrix® boosts your body and protect them from the body’s immune system to produce flu. What is shingles? more antibodies to fight the shingles Shingles is a virus. It causes a painful virus. blistering skin flare-up that is common The Shingrix® vaccine is covered by FOR MORE INFORMATION among people older than 50.
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