Alameda Alliance Wellness (HMO D-SNP) coordinates your Medicare and Medi-Cal benefits under one health plan to help you get the most out of your coverage. Our plan offers enhanced benefits beyond what Medicare and Medi-Cal traditionally cover. You must be a resident of the county Alameda and be eligible for both Medicare and Medicaid to enroll into Alameda Alliance Wellness.

View all plan details.

Join today! Call the Alameda Alliance Wellness Member Services Department to speak with a representative who can guide you through the enrollment process. We’re here to help.  

Alameda Alliance Wellness Member Services Department
Seven (7) days a week, 8 am – 8 pm, including holidays
Toll-Free: 1.888.88A.DSNP (1.888.882.3767)
People with hearing and speaking impairments (CRS/TTY): 711/1.800.735.2929 

As an Alliance member, you can choose to have a person be your authorized representative (AOR). Your AOR can communicate with us on your behalf. We will work with this person just as we would with you. Your AOR may act for you in most health care matters, and receive and disclose your Personal Health Information (PHI).

To request an AOR, please complete the form below:
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The Compliance Incident Report form is confidential and may be used to report any suspicious incidents you see or hear. (I.e. HIPAA privacy health information disclosures, fraud, waste and abuse, or any compliance issues.)

To report a potential compliance issue, please complete the form below:
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You may also report by calling the Alliance Compliance Department Hotline. Callers can choose to report issues anonymously. The Alliance Compliance Hotline is accessible 24 hours a day, 7 days a week, toll-free at 1.844.587.0810.

For more information, please view the Compliance page.

For examples of health care fraud, please view Fraud Prevention.

As an Alliance member, you have the right to choose how your protected health information (PHI) is shared. You may also ask to be contacted at a different location (mailing address, phone number, or email address) than on your account. To request changes to how confidential (private) medical communications reach you, you must complete and submit the form below.

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Your satisfaction is important to us! If you have a problem with the Alliance, you have the right to make a complaint. This is also called filing an appeal or a grievance. An appeal is when you ask for review of an “Adverse Benefit Determination.”

If you have a grievance or appeal, you may file it by phone, online, or by filling out the Alliance Member Grievance form. Your provider may also file an appeal for you.

To file a grievance, please complete the form below:
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For more information, please view Grievances & Appeals.

Additional Information for Alameda Alliance Wellness members:  

You may also submit a complaint directly with the Centers for Medicare and Medicaid Services (CMS).  

Click here to access the online CMS complaint form. 

To file a prescription drug (Rx) appeal please complete the form below: 

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To start or decline sharing immunization (shot)/tuberculosis (TB) information, please complete the form below:
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You may submit a Request for Medicare Prescription Drug Coverage Determination to ask for a medication that is not on the Alliance Medication Formulary or has restrictions. This request is called an exception request when the Alliance does not have a Medication Review Guideline (also known as criteria) for the medication. The exception request is reviewed on a case-by-case basis and for evidence of medical necessity. The Alliance will review the request and will inform the doctor of the decision within 24 hours (for urgent requests) or 72 hours (for non-urgent requests) from the time received. 

To request a Medicare Prescription Drug Coverage Determination, please complete the form below: 

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The Medicare Prescription Payment Plan is an optional program that can help Medicare members manage their out-of-pocket costs. The program allows members to spread the cost of a prescription drug throughout the year. Instead of paying the pharmacy, members who enroll will get a bill from our plan to pay for prescription drugs.   

To enroll in the Medicare Prescription Payment Plan, please complete the form below:  

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If you paid for a service that you think the Alliance should cover, you will need to complete a Member Request for Reimbursement Form and tell the Alliance in writing why you had to pay. You will need to include a copy of the itemized bill and proof of payment (such as receipts) with your request. The Alliance will review your request to find out if you can get money back. The Alliance will accept and review requests for reimbursement for a health expense that is received within 180 calendar days after the date the bill was paid.

Please use one (1) form for each health expense you are asking the Alliance to reimburse to you.

To request for a reimbursement  please complete the form below:
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Alliance Medi-Cal member dates of service on or after Saturday, January 1, 2022, please call Medi-Cal Rx toll-free at 1.800.977.2273

If you are an Alliance Wellness member and want to request reimbursement for drug(s) you already paid for out of pocket, please complete and submit a Request for Medicare Prescription Drug Coverage Determination and send to us.

We offer wellness materials, tools, programs, and classes to support you in living healthy.

To view and download materials and program listings by topic, please visit the Live Healthy Library.

To request paper copies, alternative formats, or a different language, please complete the form Alliance Wellness Programs & Materials Request Form.