Medi-Cal Program FAQs
How can I join Blue Shield Promise Medi-Cal?
Health Care Options (HCO) handles enrollment for Blue Shield Promise Medi-Cal. On our Medi-Cal prospects page, you can:
- Learn more about how to enroll
- Read eligibility guidelines
- Read enrollment instructions
How can I talk to Member Services?
Our Member Services agents are available to assist you 8 a.m. – 6 p.m., Monday through Friday at:
Our member agents speak English, Spanish, Chinese, Armenian, and Russian, among other languages. If you speak another language, we will help you with our interpreters.
I’m a new Blue Shield Promise Medi-Cal member. When will I get my welcome packet and ID card?
When you become a member of Blue Shield Promise Medi-Cal, you will get a welcome packet and your Blue Shield Promise Medi-Cal ID card within the first seven (7) days you are eligible. The two items will come in separate envelopes.
How can I get a new ID?
If you need a new Blue Shield Promise Medi-Cal ID card, call Member Services and they will send you a new one. You should get your new card within 7 to 10 business days.
How can I update my address with the Blue Shield Promise Medi-Cal Plan?
To update your address, you must call both your local county social services office and Blue Shield Promise Medi-Cal Member Services.
What can I do if I move out of your service area?
If you move outside of the county, but still live in California, call your eligibility worker right away. This is the person at your local county social services office who can help you. They can help you find out what Medi-Cal services are available in your new community.
How can I change my primary care physician?
How do I see a specialist?
If you need to see a specialist, your primary care physician (PCP) will refer you. The services must be approved before you receive them. This is also known as a referral. You do not need a referral for the following:
- PCP visits
- Network Certified Nurse Midwife OB/GYN visits
- Urgent or emergency care visits
- Family planning
- Basic prenatal care from a provider who works with Blue Shield of California Promise Health Plan
- HIV testing and counseling (only minors 12 years or older)
- Treatment for sexually transmitted infections (only minors 12 years or older)
- Minors also do not need a referral for:
- Outpatient mental health for:
- Sexual or physical abuse
- When you may hurt yourself or others
- Pregnancy care
- Sexual assault care
- Drug and alcohol abuse treatment
- Outpatient mental health for:
What should I do if I need mental health services?
How can I use Blue Shield Promise Medi-Cal transportation services?
What happens if I’m out of the county, and I need emergency care?
If you have an emergency when you are not in our service area, you can go to the nearest emergency facility (doctor’s office, clinic, or hospital). Emergency services do not need an okay from your primary care physician.
You can get urgent or emergency care anywhere in the United States, Canada, or Mexico when you need it.
What if I have Blue Shield Promise Medi-Cal, and I also qualify for Medicare benefits?
If you are a Medi-Cal member and you are eligible for Medicare, it is important you know that Medicare is your primary insurance. Blue Shield of California Promise Health Plan also offers Medicare coverage. If you are interested in combining your benefits into our Blue Shield Promise Cal MediConnect Plan, please call Member Services for more information on the additional benefits available.
What should I do if I get a bill for covered services?
Is my medical information protected?
There are federal and state laws that protect the privacy of your medical records and personal health information. We protect your personal health information under these laws. Any personal health information that you give us when you enroll in this plan is protected. We ensure that unauthorized people don’t see or change your records. .
If you have questions or concerns about privacy of your personal information and medical records, please call Blue Shield Promise Medi-Cal Member Services..
Member rights and responsibilities
Find out about your rights and responsibilities as a Blue Shield Promise Medi-Cal member.
Appeals and grievances
Learn how to file a complaint, grievance, or an appeal.
Get the Member Handbook (Evidence of Coverage) and other important documents for your area.
Learn about plan benefits and programs.