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Medi-Cal

How can I join the Alliance?

You can select the Alliance as your health plan on your Medi-Cal Choice Form if:

  • You have Medi-Cal.
  • You are eligible to be in a managed care health plan.
  • You live in Alameda County.

You can request a copy of the Medi-Cal Choice Form from the California Department of Health Care Services (DHCS) Medi-Cal Managed Care Health Care Options (HCO) program.

If you would like to learn more about eligibility, enrollment, disenrollment, and changing health plans, please contact us or call:

Medi-Cal Managed Care/Health Care Options (HCO)
Toll-Free: 1.800.430.4263
People with hearing and speaking impairments (TTY): 1.800.430.7077
www.healthcareoptions.dhcs.ca.gov

HCO is contracted with the state to provide enrollment assistance and can help you select a managed care health plan.

To find your local Alameda County Social Services Agency office, please click here.

How will I know when my Medi-Cal coverage starts with the Alliance?

It may take up to 15-45 days after you fill out the Medi-Cal Choice Form for you to become an Alliance member. Health Care Options (HCO) will send you a letter when you become a member of the Alliance. The Alliance will also mail your member ID card and member materials seven (7) days after your coverage starts. Your coverage will always begin on the first day of the month.

If you would like to learn more about eligibility, enrollment, disenrollment, and changing health plans, please contact us or call:

Medi-Cal Managed Care/Health Care Options (HCO)
Toll-Free: 1.800.430.4263
People with hearing and speaking impairments (TTY): 1.800.430.7077
www.healthcareoptions.dhcs.ca.gov

HCO is contracted with the state to provide enrollment assistance and can help you select a managed care health plan.

To find your local Alameda County Social Services Agency office, please click here.

What does Medi-Cal cover?

Medi-Cal provides comprehensive health care coverage for those who meet income guidelines.
General services and benefits of Medi-Cal include:

  • Hospital care
  • Interpreter services
  • Lab tests
  • Maternity and well-baby care
  • Prescription medication
  • Routine care with your own doctor
  • Specialty care
  • Transportation for special circumstances

To learn more about your benefits and covered services, please view your Alliance Medi-Cal Member Handbook.

For more information, you can also visit the Medi-Cal website.

I have Medi-Cal and I would like to go to Kaiser. How does this process work?

To switch to another health plan, call Health Care Options at 1.800.430.4263 (TTY 1.800.430.7077) Monday through Friday, 8 a.m. to 6 p.m. The call is free. Or visit https://www.healthcareoptions.dhcs.ca.gov/.

I have been informed that my Medi-Cal benefits are on hold. What should I do?

If your Medi-Cal benefits are on hold, you should contact the Alameda County Social Services Agency to talk to your eligibility worker. The eligibility worker will inform you if your benefits can be reinstated. If you do not know how to reach your eligibility worker, you can find your local office by visiting the Alameda County Social Services Agency website.

How do I request transportation?

To arrange or follow up on a request for transportation through the Alliance’s transportation provider, Modivcare, please call Alliance transportation services toll-free at 1-855-891-7171 at least three (3) business days before your appointment. For urgent appointments, please call as soon as possible. Please have your Alliance member ID card ready when you call.


Group Care

How can I join the Alliance?

In-Home Supportive Services (IHSS) home care workers may qualify for Alliance Group Care through the Alameda County Public Authority for IHSS.

To find out if you are eligible for Alliance Group Care, please contact:

Alameda County Public Authority for IHSS
Phone Number: 1.510.577.3551
ac-pa4ihss.org

Once you become an Alliance Group Care member, we will send you an Alliance member ID card before your effective date.

How will I know when my Alliance Group Care coverage starts?

The Alliance will mail you a new member packet seven (7) days after your coverage starts.  Your coverage will always begin on the first day of the month.

What does Alliance Group Care Cover?

Alliance Group Care provides low-cost health care coverage to In-Home Supportive Services (IHSS) workers in Alameda County.

Benefits include:

  • Routine care from your own doctor
  • Specialty care
  • Hospital care

To learn more about your benefits and covered services, please view your Alliance Group Care Member Handbook.


General Questions

Reasons to enroll in a health plan
  • I want help finding doctors, specialists, and other providers.
  • I want a list of doctors and other providers I can go to.
  • I want help getting interpreters and information in my language.
  • I want help finding care that is accessible to me.
  • I want help if I need to file a complaint or an appeal.
  • I want help coordinating my care.
How do I get a new Alliance Member ID Card?

It’s quick and easy for Alliance members to print a temporary Alliance member ID card or to request a new one.

To request for a new card, please log in to your online Alliance Member Portal or call:

If you do not have access to a printer, you can request to have a new card mailed to you at no cost.

When you get your Alliance member ID card, please check all information to make sure it is correct.

Do you need to create an Alliance Member Portal account? We can help!

How do I choose a primary care provider (PCP)?

Having a doctor (also called a primary care provider or PCP) that you can trust and talk to is very important to your health. You can find a list of PCPs who are in our network in the Alliance Provider Directory. You can choose any PCP who is accepting new patients.

To submit your choice, please log in to your online Alliance Member Portal or call:

Your new choice will become your PCP on the first day of the next month after you make the change.

You can choose a new PCP at any time for any reason. The PCP you pick must be taking new patients. If you need help choosing a PCP, please let us know.

You may also choose a county clinic or a community health clinic that is part of the Alliance network as your PCP. All Federally Qualified Health Centers (FQHCs) in Alameda County are part of our network.

If you change PCPs, you will get a new Alliance member ID card in the mail within 10 business days. It will have the name of your new PCP.

What will happen if I do not choose a primary care provider (PCP)?

Choosing a PCP is very important. If you do not choose a PCP within 30 days of becoming an Alliance member, we will assign one to you. You can choose a new PCP at any time, for any reason. The PCP you choose must be taking new patients. We will let your PCP know of your choice within 10 days after you are assigned or choose a PCP.

I received a medical bill from my provider, what should I do?

If you receive a bill from your provider, please contact the provider to make sure they did not send it to you by mistake. Medi-Cal providers should send the bill directly to the Alliance for payment. However, due to reasons such as not having the correct coverage information, they may not know where to submit the bill.

If you cannot resolve the problem directly with the provider, please call:

We will need the following information:

  • Full name and Alliance member ID number of the person who received the service
  • Date of the medical service
  • The doctor’s/hospital name
  • A copy of the itemized bill, and bill total amount

Once we receive a copy of the bill, we will review it. If you were eligible for the service, we will send the payment to the provider.

Please Note: If you receive bills for Alpha-fetoprotein (AFP) screenings, or Mental Health services provided by ACCESS, please do not send them to the Alliance. These services are covered through other programs.

For payment information, please call:

Alpha-fetoprotein (AFP) screenings
Toll-Free: 1.866.718.7915

Mental Health services provided by ACCESS
Toll-Free: 1.800.491.9099

What do I need to do in order to see a specialist?

The first thing you should do if you need to see a specialist is talk with your primary care provider (PCP). Your PCP will be able to decide whether you need a referral to a specialist in the Alliance network, or an authorization for a specialist outside of the Alliance network.

What do I do if I am temporarily outside of the Alameda County area and need medical services?

If you are temporarily outside of Alameda County (such as on vacation), you are eligible to get emergency services at any hospital. Please show your Alliance member ID card to the hospital so they know who to bill.

To learn more about your benefits and covered services, please select your health care program:
Medi-Cal | Alliance Group Care

What should I do if I have a medical emergency?

Call 911 or go to your nearest hospital emergency room (ER) if you have an emergency. An emergency is a sudden medical problem with severe symptoms that need treatment right away. For examples and guidance, please see our ER Usage Guide.

To view the ER Usage Guide, please select your preferred language:
English | Spanish | Chinese | Vietnamese

If you are unsure about where to go for care, please call your doctor first. Your doctor expects you to call any time there is a problem, even if it is at night or on the weekend.

If you have Alliance Medi-Cal or Group Care and you are temporarily outside of Alameda County (such as on vacation), you are eligible to receive emergency services at any hospital. Please show your Alliance member ID cards to the hospital so they know who to bill.

To learn more about after-hours care, the Advice Nurse Line, or urgent care, please click here.

To learn more about your benefits and covered services, please select your health care program:
Medi-Cal | Alliance Group Care

How do I get eye care services?

As an Alliance member, you have access to eye care services. You can schedule an eye exam without a doctor’s referral.

To learn more about your benefits and covered services, please select your health care program:
Medi-Cal | Group Care

How do I get dental care services?

As an Alliance member, you may have access to dental care services.

To learn more about your benefits and covered services, please select your health care program:
Medi-Cal | Alliance Group Care

How do I create an Alliance Member Portal account?
  1. Visit the Alliance Member Portal.
  2. Select: Click here to create your user account.
  3. Choose a username and password.

If you would like more help, please call:

How do I reset my Alliance Member Portal account password?
  1. Visit the Alliance Member Portal.
  2. Select: If you forgot your username or password, click here.
  3. Select what you have forgotten.

If you would like more help, please call:

What medications are covered?

The Alliance Medication Formulary is a list of approved medications. This list of medications is approved by the Alliance Pharmacy and Therapeutics (P&T) Committee. These medications are selected based on safety and quality. These medications are a part of your covered benefits and do not require prior authorization. A medication that is not on the list is called a non-formulary medication. A non-formulary medication may be approved if your doctor request a prior authorization and provides the reason why you need a non-formulary medication.

For more information, please view the Alliance Medication Formulary.

My doctor says I need a medication that is not in the Alliance Medication Formulary. What should I do?

If you need a medication that is not on the Alliance Medication Formulary, your doctor must request prior authorization (PA) from the Alliance. Please ask your doctor to submit a Prescription Drug Prior Authorization (PA) Request to the Alliance.

My pharmacist says I have to pay full price for my prescription. What should I do?

If this happens, be sure the pharmacist has seen your Alliance member ID card.

If you do not have your card, please ask the pharmacist to call:

My pharmacist says my prescription is not covered under my plan. What should I do?

If this happens, ask for specific reasons why it is not covered.

Please ask the pharmacist to call:

PerformRx
Monday – Friday, 8 am – 5:30 pm
Toll-Free: 1.855.508.1713

If PerformRx is unable to assist, please ask the pharmacist to call:

  • Alliance Pharmacy Services Department
  • Monday – Friday, 8 am – 5 pm
  • Phone Number: 1.510.747.4541