Blue Shield Promise Medi-Cal Members

Blue Shield Promise Medi-Cal members

Blue Shield of California Promise Health Plan currently serves Medi-Cal members in Los Angeles and San Diego Counties. In Los Angeles County we are contracted with L.A. Care Health Plan. In San Diego County we are contracted with the Department of Health Care Services. 

Medi-Cal gives adults and children an important group of health benefits. The Affordable Care Act makes sure that all Medi-Cal health plans offer the “essential health benefits.”

Medi-Cal benefits may include:

  • Medical care
  • Pharmacy and prescription drugs 
  • Vision care
  • Long-term services and support
  • Transportation services
  • Dental care

Dental benefits are available to Medi-Cal members who qualify through Denti-Cal provided by the Department of Health Care Services (DHCS). To learn more about Denti-Cal’s  coverage please visit their website or call them at (800) 322-6384 [TTY: 711].

Get to know your plan to better understand services available to you. To find out what benefits your plan covers, read plan details in your Member Handbook (Evidence of Coverage). You can also review our benefits information pages.

If you are not enrolled in Blue Shield Promise Medi-Cal yet, read our potential member materials, You should also read our eligibility and enrollment information.

Blue Shield Promise Medi-Cal highlights

Award-winning care

Blue Shield Promise Medi-Cal earned National Committee for Quality Assurance (NCQA) Full Accreditation for its Medicare and Medi-Cal plans. 

Learn about different ways to get care

 

Prescription drugs and pharmacy benefits

Your Blue Shield Promise Medi-Cal Health Plan includes prescription drug coverage. Learn more about the drugs covered in your plan and how to fill your prescriptions. You can also learn what to do if your medication is not on the list of covered drugs.

Review the list of covered drugs

 

Health education and wellness programs

Blue Shield of California Promise Health Plan believes that the more you know, the better you can take care of yourself. We give you brochures on topics like staying fit, managing diseases, and maintaining a healthy weight. We can also help you find classes, counseling, and support groups.

Find programs and educational materials

 

Contact Blue Shield Promise Medi-Cal

If you have any questions about your benefits or the cost for care you got from your doctor or hospital, please contact us. If you receive a bill for a service, please contact us.

Los Angeles County

 Phone:(800) 605-2556 [TTY: 711], 8 a.m. - 6 p.m., Monday – Friday.

 Fax: (323) 889-6236

Email us

  Blue Shield of California Promise Health Plan
Member Services
601 Potrero Grande Dr.
Monterey Park, CA 91755

 

San Diego County

 Phone:(855) 699-5557 [TTY: 711], 8 a.m. - 6 p.m., Monday – Friday.

 Fax: (619) 528-4820

Email us

  Blue Shield of California Promise Health Plan
Member Services
601 Potrero Grande Dr.
Monterey Park, CA 91755

Get to know your Medi-Cal program

Get to know your health plan: learn more about your rights and responsibilities, see how to file an appeal or a grievance, and read answers to frequently asked questions.

Get to know your plan

Read FAQs

Learn how to submit an appeal or a grievance

Submit a grievance form online

Learn how to renew your Medi-Cal coverage

Plan documents

Download a comprehensive plan description, get a sample member ID card, find documents in your preferred language, and get other important notices.

View Member Handbook (Evidence of Coverage)

Get language assistance and translation services

Find other plan documents and notices

Find a provider or pharmacy

Use our tool for the most up-to-date listing of doctors, specialists, pharmacies, hospitals, behavioral health services, and vision care providers in your area. You can also download or request a copy of provider directory.

Find a Medi-Cal provider

Benefits information

Find information about the benefits, services, and programs covered by Blue Shield Promise Medi-Cal. Learn what to do if a service or a procedure requires prior authorization.

Learn about your medical benefits

Prescription drug benefit information

Access and search our formulary. Review drug prior authorization guidelines and other medication related policies. Get pharmacy directories and learn about our mail service pharmacy and non-network coverage.

Learn about the prescription drug benefit

Member resources and links

Learn about our quality improvement initiatives, request a member ID card, change your primary care doctor and find information about our outreach program and community events.

Find useful resources and tools

Health and wellness programs and resources

Take charge of your health with our Health and wellness member tools. Find information on healthy living programs and educational materials on topics like being active and managing chronic conditions.

Find programs and educational materials

Access Health and wellness member site

Do you need Medi-Cal?

Get more information and learn how to enroll using the following resources:

View potential Medi-Cal recipient information

Learn how to apply

The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at (Los Angeles:(800) 605-2556 (TTY: 711), San Diego: (855) 699-5557 (TTY: 711),) and use your health plan’s grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you.

If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number ((888) 466-2219) and a TDD line ((877) 688-9891) for the hearing and speech impaired. The department’s internet website www.dmhc.ca.gov has complaint forms, IMR application forms, and instructions online.

 

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Blue Shield of California Promise Health Plan has neither reviewed nor endorsed this information.

Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. Blue Shield of California Promise Health Plan is a Medicare Advantage HMO plan with a Federal Government contract in California. Enrollment in Blue Shield of California Promise Health Plan depends on contract renewal.

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