Medi-Cal Program FAQs

See the questions our Blue Shield of California Promise Health Plan members ask most frequently about the Medi-Cal program. You can also find more information in your Member Handbook (Evidence of Coverage)

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

 

Our Member Services agents are available to assist you 8 a.m. – 6 p.m., Monday through Friday at:  

  Los Angeles:(800) 605-2566 (TTY: 711)
  San Diego: (855) 699-5557 (TTY: 711)
  Email Member Services

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.


 

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.


 

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.

  Phone: Los Angeles: (800) 605-2556 (TTY: 711), 8 a.m. – 6 p.m., Monday through Friday.
  Phone: San Diego: (855) 699-5557 (TTY: 711), 8 a.m. – 6 p.m., Monday through Friday.

You can also ask for a new ID card online.


 

To update your address, you must call both your local county social services office and Blue Shield Promise Medi-Cal Member Services. 

Los Angeles County Department of Public Social Services:
  (800) 605-2556 [TTY: (800) 660-4026], 7:30 a.m. to 5:30 p.m., Monday through Friday.

San Diego County Health and Human Services Agency:
  (866) 262-9881 [TTY: (619) 589-4459], 7 a.m. to 5 p.m., Monday through Friday.


 

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.

Los Angeles County Department of Public Social Services:
  (800) 605-2556 [TTY: (800) 660-4026], 7:30 a.m. to 5:30 p.m., Monday through Friday.

San Diego County Health and Human Services Agency:
  (866) 262-9881 [TTY: (619) 589-4459], 7 a.m. – 5 p.m., Monday through Friday.


 

You can change your primary care physician at any time by calling our Member Services department or by submitting a request online. It may take up to 30 days for the change to take effect.

  Phone: (800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.


 

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

See the “Covered Benefits” section in your Member Handbook (Evidence of Coverage) for a complete list.


 

You are eligible to receive mental health services. Find more information about how to get mental health services.


 

As a member, you are eligible for transportation services to all Medi-Cal services. Some restrictions may apply. Please visit the transportation page for further information.


 

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.


 

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.

  Phone: (800) 820-6009 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.

Or visit the Blue Shield Promise Cal MediConnect’s website.


 

You should not get a bill for any covered services. If you do, please call Blue Shield Promise Medi-Cal Member Services.

  Phone: Los Angeles: (800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.
  Phone: San Diego: (855) 699-5557 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.


 

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. Learn more about our privacy policies

If you have questions or concerns about privacy of your personal information and medical records, please call Blue Shield Promise Medi-Cal Member Services..

  Phone: Los Angeles: (800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.
  Phone: San Diego: (855) 699-5557 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.


 

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.

Plan documents

Get the Member Handbook (Evidence of Coverage) and other important documents for your area.

Benefits information

Learn about plan benefits and programs.

Health Care Options: (844) 580-7272  {TTY: {800) 430-7077}, Monday through Friday from 8 a.m. — 6 p.m. 

For information on Blue Shield Promise plans for your health care, call the Department of Health Care Services at (800) 430-4263 {TTY: (800) 735-2922}, or visit https://www.healthcareoptions.dhcs.ca.gov/.

Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal Plans.

© 2002-2024. California Physicians’ Service DBA Blue Shield of California Promise Health Plan. All rights reserved.

California Physicians’ Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association.

The provider network may change at any time. You will receive notice when necessary.

Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascedencial, religión, sexo, estado civil, genero, identidad de genero, orientación sexual, edad ni discapacidad.

Blue Shield of California Promise Health Plan 遵循適用的州法律和聯邦公民權利法律,並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。

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Blue Shield of California Promise Health Plan, 3840 Kilroy Airport Way, 
Long Beach, CA  90806

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