◈ Homepage — https://www.caloptima.org/Skip to main content Enable accessibility for low vision Open the accessibility menu This website utilizes technologies such as cookies to enable essential site functionality, as well as for analytics and personalization. Essential cookies are required to enable basic website functionality. You may not disable essential cookies. By clicking “Accept”, closing this banner, or by continuing to use this website without closing this banner, you consent to the use of non-essential cookies and similar technologies on this website to personalize your experience, perform analytics, and for other business purposes. You can obtain more information and block some of these technologies by clicking the “Cookie Preferences” icon. By using this website, you agree to our website Privacy Policy Accept Deny Non-Essential Skip to Main Content Customer Service Call Us For Providers Public Meetings Community Impact About Us Careers Health Insurance Plans Find a Doctor Health and Wellness English Search Portal Login New! Check out HealthHub for helpful information and tools at any time of the day. Your Health Is Everything to Us Orange County, CalOptima Health is here for you! We offer health insurance plans for low-income children, adults, seniors and people with disabilities. We provide all-around care for members to meet the needs of the whole person. Because housing is health. Food is health. And so much more is health. That’s why we say, “Your Health Is Everything to Us.” Find a Doctor Member Login ELIGIBILITY Medi-Cal Changes Begin in 2026 Medi-Cal eligibility and benefits are changing for some adults starting in 2026. Learn more about the new rules and how they affect your coverage.  Medi-Cal Changes QUALITY CARE Find a Doctor CalOptima Health works with thousands of Orange County providers, including doctors, specialists, hospitals, health networks, medical groups and more. Find the right providers for your needs. Find a Doctor MEDI-CAL RENEWAL Protect Your Coverage Take action to protect your Medi-Cal coverage by reporting new contact information or family changes to the County of Orange Social Services Agency. Look for the yellow envelope in the mail with your annual renewal forms. Renewal Info RESOURCES You Can Report Fraud or Abuse If you see any activity that you think is fraud or waste, we strongly encourage you to call our Compliance and Ethics Hotline at 1-855-507-1805 (TTY 711). You can also report the activity using CalOptima Health’s Compliance and Fraud, Waste and Abuse (FWA) Reporting form. You do not have to give your name to report fraudulent activity. Report Fraud and Abuse Our Plans Medi-Cal California’s Medicaid Plan No-cost health coverage for low-income families with children, seniors, people with disabilities, foster care children, pregnant women, and low-income people with specific conditions. Explore Medi-Cal OneCare Medicare Advantage Dual Eligible Special Needs Plan Coordinated care for low-income seniors and people with disabilities who qualify for both Medicare and Medi-Cal. Benefits are combined in one single plan, making it easier to get health care. Explore OneCare PACE Program of All-Inclusive Care for the Elderly Comprehensive health care to keep frail elders active and living at home. PACE combines preventive, primary and acute care along with day health services in one plan for seniors with Medi-Cal only or Medicare and Medi-Cal. Explore PACE About CalOptima Health 34 Orange County Cities Served COMMUNITY-BASED Who We Are CalOptima Health offers health insurance plans for low-income children, adults, seniors and people with disabilities in Orange County. Local leaders launched CalOptima Health in 1995 as a county organized health system to better serve vulnerable residents and provide access to quality health care. CalOptima Health operates independently, under the leadership of a Board of Directors made up of members, providers, business leaders and local government representatives. About Us 915K+ Members Served MEMBER-FOCUSED What We Do CalOptima Health members have access to care from one of three health plans:  Medi-Cal: Medi-Cal is California’s Medicaid program for low-income children, adults, seniors and people with disabilities.  OneCare: OneCare is a Medicare Advantage plan that combines the benefits of Medi-Cal and Medicare for seniors and people with disabilities.  Program of All-Inclusive Care for the Elderly: PACE is for seniors in need of a full range of health and social services so they can remain living at home. View Health Plans 30 Years of Serving OC MISSION-DRIVEN Why It Matters CalOptima Health is the single largest health insurer in Orange County, and we cover nearly one in three residents. About a third of our members are children, so we are responsible for caring for the next generation in our community. We believe in health equity and access to care for all, and we serve members in the languages they prefer so they are engaged in their health and realize better outcomes. When our members are healthy, Orange County is healthier. View Our Community Impact Additional Resources Previous Next Show slides 1 through 4 of 5 RESOURCES Access to Care for All CalOptima Health is dedicated to providing access to health care for all members, regardless of immigration status. Virtual care is a way to receive health services during challenging times when in-person visits may be difficult.  See Access to Care Resources PREVENTIVE CARE Cancer Screening Through the Comprehensive Community Cancer Screening and Support program, CalOptima Health is focused on boosting screening rates for breast, cervical, colon and lung cancer. Learn more about when to get screened, what to do about test results and how to manage cancer care. About Cancer Screening MORE BENEFITS CalAIM California Advancing and Innovating Medi-Cal (CalAIM) is a statewide initiative to improve the quality of life and health outcomes of Medi-Cal members. CalAIM offers benefits that address the social drivers of health care, such as housing and food security. About CalAIM PUBLIC MEETINGS Public Meetings and Materials CalOptima Health welcomes participation in our public meetings. Get the latest schedule and materials for Board of Directors, Board committee and advisory committee meetings.  See Public Meetings PARTNERSHIP Community Relations CalOptima Health’s Community Relations team collaborates with local organizations to support our members. Learn more about our sponsorships, educational programs, health resources and events. About Community Relations Medicare.gov Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map ◈ Interior Pages — 10 pages crawled2026 OneCare HMO D-SNP Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. 2026 CalOptima Health OneCare CalOptima Health OneCare supports seniors and people with disabilities who are enrolled in both Medicare and Medi-Cal. View Benefits Enroll Today Member Story: Jesús and Estela Arias Watch video Menu Loading component... Find a doctor:  Use Find a Doctor to look for primary care providers (PCPs), urgent care centers and other health care providers. Get answers to your questions: Call CalOptima Health Customer Service toll-free at 1-877-412-2734 (TTY 711 ). We have staff who speak your language. Get health services at home: Go to Access to Care for All to find out how you can get virtual care (telehealth) and other resources.  Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... OneCare Benefit Sessions No Upcoming Events Loading component... Loading component... Loading component... Loading component... Loading component... OneCare New Member Orientation Sessions No Upcoming Events Loading component... OneCare Member Forms Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Your Health Is Everything to Us Get the care you need now. Please call us if you need support. CalOptima Health OneCare (HMO D-SNP) Combines Your Medicare and Medi-Cal Benefits To qualify to be a OneCare member you must:  Live in Orange County Have Medicare Parts A and B Have full Medi-Cal with no Share of Cost Be age 21 or older Medicare + Medi-Cal Educational Video Watch our educational video to learn about the basics of Medicare + Medi-Cal, plan options for dual-eligibles, and how OneCare is the plan built around our members.   Play Video Close Modal CalOptima Health OneCare Complete — the Plan That’s Built Around You Our OneCare Complete plan supports your needs, so you can focus on what’s most important — your health. Here are just a few of your 2026 benefits. OneCare Complete Flex card: Over-the-counter (OTC) items/healthy food and produce* $167 per quarter and no rollover of unused funds Prescription Medicines (Part D premium coverage) $0 generic medicines. Standard Part D copays based on low-income status up to $12.65 for brand-name medicines Vision Annual exam and up to $500 for eyeglasses, contact lenses and repairs every 2 years Hearing Up to $500 for hearing aids. Medi-Cal may cover up to an additional $1,510 Comprehensive dental† Yes Fitness benefit Yes Transportation Unlimited trips to and from the gym (10-mile radius) Worldwide emergency room coverage Up to $100,000 reimbursement per year Annual physical exam Once per year In-Home Support Services — Companion Care Up to 90 hours per year Erectile Dysfunction Medicines 6 pills per month Healthy Food and Produce Benefit To find out if you qualify to buy healthy food and produce with your flex card: Call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711 ). Or, download the 2026 Healthy Food and Produce Benefit form and ask your doctor to fill it out. This benefit is a Special Supplemental Benefit for the Chronically Ill (SSBCI). To qualify, you must have a qualifying chronic condition such as heart disease, diabetes, cancer, lung disease or dementia. Not all members with a chronic condition will qualify. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please see Chapter 4 in the CalOptima Health OneCare Complete Member Handbook. Comprehensive Dental † CalOptima Health OneCare works with Liberty Dental Plan to provide you with comprehensive dental services that add to the services you can get through Medi-Cal Dental. Click below for more information about which dental services CalOptima Health OneCare covers and how they work. 2026 CalOptima Health OneCare Dental Benefits and Medi-Cal Dental Benefits 2026 Liberty Dental Plan Benefits 2026 Liberty Dental Plan Frequently Asked Questions For a full list of services covered by Medi-Cal Dental, call 1-800-322-6384 (TTY 1-800-735-2922 ) or visit Smile, California. These resources can also help you locate a Medi-Cal Dental provider and file a grievance or complaint. Let us Support Your Health Rest easy — with OneCare, our team will help you plan services and benefits that best fit your health care needs. We’ll support you with: Personal Care Coordinator (PCC) Someone who can answer your questions and help plan your health care Health Assessment A survey to help us understand and support your current medical and social needs Care Team The people who know your health care needs best and who work together to support your care Care Plan A document that organizes and guides your care needs Case Management Members with more complex health needs may qualify for extra services that help with care coordination. Learn more about case management. Benefit Session: Learn About Medicare Join one of our benefit sessions to see if OneCare is right for you. Find out how to maximize and combine your Medicare and Medi-Cal benefits Plus learn the basics from our experts See More Events Enrolling in OneCare Is Simple and Easy! You can download an enrollment form and mail it to the address below. For more information, please call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711 ), 24 hours a day, 7 days a week. We have staff who speak your language. Print and complete the enrollment form to apply for OneCare and mail it to: CalOptima Health Attention: OneCare Customer Service 505 City Parkway West Orange, CA 92868 Download Enrollment Form New CalOptima Health OneCare Members: Start Here CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan, combines your Medicare and Medi-Cal benefits in a single plan, making it easier to get the health care you need. With OneCare, you can choose from more than 8,000 doctors and specialists in Orange County who are ready to serve you. What to Expect After Enrolling Confirmation Letter With Your Effective Date of Coverage Within 10 days of enrolling, you’ll get a confirmation of enrollment letter in the mail. You should keep this letter. It serves as proof that Medicare has approved your enrollment form. Welcome Kit and Member ID Card You’ll get a welcome kit from CalOptima Health OneCare that has your member ID card. Be sure to bring your new member ID card when you visit your doctor, hospital and pharmacy. Flex Card Benefit Information You’ll get a debit card and instructions on how to use it. Expect a Health Assessment Phone Call You’ll get a call from a CalOptima Health OneCare Personal Care Coordinator (PCC) who will ask about your health history, your current health status and the services you may need. Your answers will help us get the right care for you. Important Steps for New Members Step 1 Sign up to Access Your CalOptima Health OneCare Member Portal CalOptima Health’s website makes it easier for you to find what you need using any device. A secure online member portal lets you: Update your personal information Request a new member ID card Print a copy of your member ID card Change your health network or primary care provider (PCP) Request interpreter services How to Sign Up and Log In to Your OneCare Member Portal  Visit Member Portal Step 2 Learn About Your OneCare Benefits The CalOptima Health OneCare Member Handbook, also known as the CalOptima Health OneCare Evidence of Coverage, tells you what’s covered under our plan. It explains health care services, behavioral health (mental health and substance use disorder) services, prescription drug coverage, and long-term services and supports. To get a complete list of services we cover, read the Member Handbook If you want a Member Handbook mail Access to Care Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Access to Care for All CalOptima Health is dedicated to providing access to health care for all members, regardless of immigration status. Below are CalOptima Health’s many virtual care options and immigration resources for members. On July 17, 2025, news reports stated that the Centers for Medicare & Medicaid Services agreed to share the personal data of all Medicaid members nationwide with the Department of Homeland Security. Medicaid is called Medi-Cal in California. CalOptima Health has not shared or been asked to share member information with federal agencies. A Letter to Our Members To our members: Your health is everything to us. Please reach out for support if you need it. Medi-Cal Customer Service Department 1-888-587-8088 OneCare Customer Service Department 1-877-412-2734 PACE Customer Service Department 1-714-468-1100 Virtual Care Options Virtual care is a way to receive health services during challenging times when in-person visits may be difficult. Loading component... Loading component... Loading component... Loading component... Virtual Doctor Visits Many of CalOptima Health’s Primary Care Providers (PCP) offer virtual visits. Check with your PCP and ask if virtual care is an option for you. Use our Find a Doctor Search Tool to look up your PCP. See a list of Medi-Cal PCPs that offer telehealth See a list of OneCare PCPs that offer telehealth Nurse Advice Line CalOptima Health offers a Nurse Advice Line at 1-844-447-8441 (TTY 1-844-514-3774 ) so you can speak with a professional nurse 24 hours a day, 7 days a week to help you decide what care you need.  The nurse can help: Figure out your symptoms and what you can do Explain your condition or your diagnosis Medicine Home Delivery Medi-Cal Members  Search for mail-order pharmacies on the Medi-Cal Rx website by using the display filter for “mail order” after you search for a pharmacy near you. You can also call the Medi-Cal Rx call center for assistance locating a mail-order pharmacy at 1-800-977-2273 (TTY 711 ), 24 hours a day, 7 days a week. OneCare Members Choose mail-order pharmacy service with our new 2026 mail-order pharmacy, SortPak. Call 1-877-570-7787 (TTY 711 ) or visit the SortPak website to get started. Virtual Mental Health Services Members experiencing anxiety, depression or other mental health concerns can call the CalOptima Health Behavioral Health line toll-free at 1-855-877-3885 (TTY 711 ) for referrals, 24 hours a day, 7 days a week. We have staff who speak your language. Behavioral Health Provider Search   Many of CalOptima Health’s Behavioral Health providers offer virtual visits. Check with your provider and ask if virtual care is an option for you. See a list of CalOptima Health Behavioral Health providers TeleMed2U  Book a confidential, no-charge video or phone call with a TeleMed2U licensed behavioral health provider. Visit the Member Portal for how to book an appointment or call TeleMed2U toll-free at 1-844-585-9210 . Virtual Behavioral Health for Kids   BrightLife Kids offers free, expert coaching to families with children ages 0–12. No insurance or referrals are needed. All services are free and confidential. (Also available as a mobile app) Virtual Mental Health for Teens and Young Adults  Soluna offers teens and young adults ages 13–25 a safe space to explore mental health concerns and seek support. Sessions are unlimited, free, and don’t require insurance. (Also available as a mobile app)  Immigration Resources for Members Immigration Support Organizations The California Department of Social Services funds qualified community-based organizations to provide free legal services and community education to immigrants who live in California. Organizations that serve Orange County and statewide   State of California Immigration Resources California makes information about legal assistance and mental health resources available on the Immigration and California Families webpage . The California Department of Health Care Services has posted Medi-Cal Immigrant Eligibility FAQs . Know Your Rights Toolkit The Immigrant Legal Resource Center offers materials to educate the community and prepare individuals for possible encounters with immigration authorities. Printable Red Cards All people in the United States, regardless of immigration status, have certain rights and protections under the U.S. Constitution. Red cards state how people can exercise these rights.  Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map Medi-Cal for Kids and Teens Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. CalOptima Health Medi-Cal Benefits and Services No matter your age or health needs, we’re here to support you. See More Services Medi-Cal Member Handbook Menu Full Health Care Benefits We provide whole-person health care at no cost to our members. With CalOptima Health Medi-Cal, you get: Loading component... More Health Care Services Access additional services from our partners.* Loading component... *Some services need prior authorization to be covered. Prior authorization is an approval for special medical services given by your health network. Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Prior Authorization for Special Medical Services Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Full Health Care Services Health care that covers each part of your well-being, from preventive care to specialist visits. Compassionate Mental Health Care Behavioral health services that help you live a balanced and fulfilling life. Essential Medical Equipment Prescribed medical equipment, supplies and more— everything you need to stay healthy. Quality Vision Care Routine eye exams, corrective lenses and expert care to help you see the world clearly. Convenient Transportation Drivers to make visiting your doctor or going to the pharmacy easier. Personalized, Long-Term Care Long-term care services and supports that offer peace of mind, so you can live independently. Case Management Members with more complex health needs may qualify for extra services that help with care coordination.  Learn more about case management. Dental Services Call Medi-Cal Dental at 1-800-322-6384 Dental Services Services for the Developmentally Disabled Call the Regional Center of Orange County: East/Central Office: 1-714-796-5100 West Area Office: 1-714-796-2900 Services for the Developmentally Disabled Services for Alcohol and Drug Problems Call the Orange County Health care Agency Alcohol and Drug Abuse Administration at 1-714-834-3840 Short-Doyle and Medi-Cal Mental Health Services Call the Orange County Behavioral Health Plan at 1-800-723-8641 (TTY 711 ) Short-Doyle/Medi-Cal and Medi-Cal Mental Health Services Whole-Child Model (WCM) Our WCM program offers enhanced care coordination, improved access to care and better health outcomes for children with conditions eligible for California Children’s Services (CCS). With WCM, your child’s Medi-Cal and CCS benefits are combined under CalOptima Health.  See WCM Member Guide Learn More About WCM and CCS Family Resource Centers (FRCs)/Family Empowerment Centers (FECs) DHCS – CCS Program Overview Learn More About the WCM Family Advisory Committee (WCM FAC) Orange County Health Care Agency – CCS Info and Resources Department of Health Care Services (DHCS) – WCM Family Voices of California – WCM Fact Sheet DHCS – CCS Advisory Group WCM Provider Training WCM Frequently Asked Questions WCM Referral Form Medi-Cal for Kids and Teens If your child or teen is under age 21 and enrolled in Medi-Cal, they may qualify for free health care services to support their growth, development and well-being. Medi-Cal for Kids & Teens covers check-ups, shots, dental care, mental health services, vision and hearing care and more—even if your child isn’t sick. These services are designed to catch health issues early and treat them before they become more serious. Learn about your child’s rights, what services are covered, and how to get care from the resources below.  Medi-Cal Rights for Kids and Teens Medi-Cal for Kids Medi-Cal for Teens Doula Support for Pregnant and Postpartum Members View the Doula Support Services Flyer We offer doula services at no cost to our Medi-Cal members who are currently pregnant or have delivered a baby within the past 12 months.  Doulas are birth workers who give non-medical support to pregnant and postpartum persons before, during and after childbirth, including support during miscarriages, stillbirths, and abortions. They can: Help you understand your health care choices Make a birth plan that fits your needs Teach you about breastfeeding Connect you with community resources Support your physical and emotional health Members can reach out to any doula in their health network to start service. No prior authorization is needed.   Questions? Call CalOptima Health Customer Service toll-free at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Covered Services Perinatal Support Access to 1 initial visit and up to 8 additional visits at any time during the perinatal period (before or after birth). Postpartum Support Up to 2 extended 3-hour postpartum visits after the end of a pregnancy with the standing recommendation issued by the Department of Health Care Services (DHCS). Labor and Delivery Support during labor and delivery, including through stillbirth, abortion or miscarriage. Additional Support Up to 9 additional postpartum visits with recommendations from a doctor or other licensed provider. This recommendation can be noted in your medical record by your provider. You can also ask your provider to complete the Doula Recommendation Form and give it to your doula. (The standing recommendation from DHCS cannot be used for additional postpartum visits.) View Doula Recommendation Form 24/7 Nurse Advice Line Call 1-844-447-8441 If you can’t get a hold of your doctor or health network, you can speak to one of our nurses 24 hours a day, 7 days a week at 1-844-447-8441 (TTY 1-844-514-3774 ). We can help:  Figure out your symptoms and what you can do Refer you to get help or see your doctor, go to urgent care or visit the hospital Explain your condition or your diagnosis Learn about your medicines Provide interpreter services by phone For medical or psychiatric emergencies, call 911 or go to the nearest hospital. Medi-Cal Rx Call 1-800-977-2273 Prescription drugs given by a pharmacy are covered by Medi-Cal Rx, a pharmacy program from the California Department of Health Care Services (DHCS). Visit the Medi-Cal Rx website to learn more and find a pharmacy near you. You can also call Medi-Cal Rx Customer Service at 1-800-977-2273 (TTY 711 ), 24 hours a day, 7 days a week. Every 3 months, CalOptima Health’s Pharmacy and Therapeutics (P&T) Committee reviews the most recent drug recalls and withdrawals. We inform you, your prescribers and pharmacies when there is a Class I or Class II medication recall or when a drug is removed from the market. See the most recent drug recalls and withdrawals: Drug Recalls and Withdrawals (02/2026) Drug Recalls and Withdrawals (11/2025) Drug Recalls and Withdrawals (08/2025) Drug Recalls and Withdrawals (05/2025) Drug Recalls and Withdrawals (02/2025) Drug Recalls and Withdrawals (11/2024) Drug Recalls and Withdrawals (08/2024) Medi-Cal Rx For some types of care, your doctor or specialist will need to ask your health network or CalOptima Health for permission before you get care, such as prior authorization, prior approval or pre-approval. Care is medically necessary if it is reasonable and necessary to protect your life, keeps you from becoming seriously ill or disabled, or relieves severe pain. Services that need pre-approval include: Hospitalization Services out of the CalOptima Health service area Outpatient surgery Long-term care at nursing facility Specialized treatments You never need pre-approval for emergency care, even if it is out of network. This includes having a baby. To request a prior authorization, contact your primary care provider (PCP) or specialist. See a list of procedure codes that require prior authorization by your provider below: 2026 Procedure Notice of Nondiscrimination Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Notice of Nondiscrimination Medi-Cal Find important documents, including Notice of Privacy Practices, Notice of Nondiscrimination and other helpful information. View Medi-Cal Other Important Documents Notice of Nondiscrimination OneCare Find important documents, including Notice of Privacy Practices, Notice of Nondiscrimination and other helpful information. View OneCare Other Important Documents Notice of Nondiscrimination PACE Find important documents, including Notice of Privacy Practices, Notice of Nondiscrimination and other helpful information. View PACE Other Important Documents Loading component... Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map Other CalOptima Health Medi-Cal Programs Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Other CalOptima Health Programs and Services We strive to get you the care you need, when you need it. That’s why as one of our members, you can get extra services at no cost to you. View Benefits Enroll Today Menu Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... More Services Loading component... Loading component... Loading component... Interpreter Services Call 1-888-587-8088 Get access to: Staff who can help you in your preferred language Free interpreter services, such as American Sign Language, for all your health care needs — no need to rely on friends or family members Interpreter services for medical services (doctor visits, after-hours care, urgent care, pharmacy services, health education classes) and non-medical services (Customer Service, member complaints and orientation meetings) 24 hours a day, 7 days a week Health education and enrollment materials in multiple languages at no cost Other formats, such as braille, audio or large print at no cost For scheduled visits, please ask for an interpreter at least 5 working days before. Simply call your health network, or you can call our Customer Service team toll-free at  1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Member Liaisons Call 1-888-587-8088 Our member liaison specialists provide services to seniors, people with disabilities or chronic conditions, people without housing and people under age 21 who participate in the Whole-Child Model program. They can: Connect you with health networks, providers, case managers and community-based organizations across Orange County to give you access to services and solve health care and social issues Help you with planning doctor visits and getting medical supplies, such as wheelchairs, wheelchair repairs and crutches Reach our member liaisons by calling our Customer Service team toll-free at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Multipurpose Senior Services Program With our Multipurpose Senior Services Program (MSSP), seniors can stay in their own homes and out of a nursing home. Our care managers work closely with you, your family and community resources to help you have a higher quality of life at home. The program is funded by the California Department of Aging. MSSP Eligibility To be part of MSSP, you must: Be 60 years of age or older Have a possible need for nursing home care Receive Medi-Cal with the right aid code Health Care Management Services Full assessments Tailored care plans Exclusive services and items for your needs Seamless connections to services that match your care plan goals Ongoing support Steady care, to make sure you don’t have any gaps Coordinated Care Services Community-Based Adult Services (CBAS) Medical supplies and non-medical supplies Personal care to help you do daily tasks Trips to and from your appointments Minor home repairs Counseling services Learn More For more info or to apply for MSSP, call us at 1-714-347-5780 , or reach out to our Customer Service team toll-free at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Supplemental Security Income (SSI) Call 1-888-587-8088 SSI is a federal program that gives people who are age 65 or older, blind or disabled with limited income monthly cash payments to buy essentials, such as food, clothing and shelter. We’re working with Centauri Health Solutions to guide you through the SSI application process. Centauri Health Solutions works with the Social Security Administration (SSA) for you at no cost and can: Help you complete paperwork Get medical records for you Plan your visits with SSA offices If you get a letter from Centauri Health Solutions, it will include details on how to get help with your SSI application. For more info, call CalOptima Health Customer Service toll-free at 1-888-587-8088 (TTY 711 ), Monday through Friday, from 8 a.m. to 5:30 p.m. We have staff who speak your language. CARE COORDIANTION Case Management Our Case Management program helps coordinate medical care, community resources and other services for members with complex medical needs. BEHAVIORAL HEALTH SUPPORT Substance Use Disorder Preventive Services Call 1-855-877-3885 or 1-888-587-8088 We offer Alcohol Misuse Screening and Counseling (AMSC) to members age 18 and older, including: Alcohol misuse screening (1 each year) using an approved screening tool (more screenings if medically needed). Up to 3 brief behavioral counseling sessions each year (more sessions if medically needed). For services to help with major alcohol-related issues, we can refer you to the Orange County Drug Medi-Cal Organized Delivery System (DMC-ODS). For more help or info, call our Behavioral Health team toll-free at  1-855-877-3885 (TTY 711 ), 24 hours a day, 7 days a week or our Customer Service team at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Helpful Resources Previous Next Doctor Search Find a Doctor Medi-Cal Benefits Explore Medi-Cal Benefits Medi-Cal Enrollment Enroll in Medi-Cal Today Mental Health Services Discover Our Mental Health Services California Advancing and Innovating Medi-Cal (CalAIM) Learn About CalAIM Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map For Providers Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. For Providers CalOptima Health’s success is a reflection of our partnerships with local health care providers. Together, we share the goal of delivering quality care that respects the dignity, value and needs of each member. As the largest health insurer in Orange County, CalOptima Health is proud that our members have access to a comprehensive network of providers that includes nearly 8,400 primary care providers and specialists, 600 pharmacies, 40 hospitals and 200 long-term care facilities.  Provider Login Provider Update Provider Notice Update 189 April 16, 2026 Menu Loading component... Loading component... Provider Search and FAQs Access our provider search tool and read frequently asked questions about our programs and processes. Provider Search Tool Provider FAQs Common Find a Provider Searches Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Provider Events No Upcoming Events Loading component... Claims and Eligibility CalOptima Health providers can use these tools to verify eligibility and benefits, check on the status of a claim, or request treatment authorizations. Verify Member Eligibility Interoperability and Electronic Data Interchange Prior Authorization Provider Portal Provider Complaint Process Coding Initiative Corner Tip Documents and Training Resources, forms and trainings to give our contracted providers the information they need to deliver the highest quality service to our members. Manuals, Policies and Guides Common Forms Clinical Practice Guidelines Provider Training Quality Information about our Quality Improvement and Health Equity program and initiatives. 2025 QIHET Program 2024 QIHET Program Evaluation 2025 Q4 QIHEC Activities Report CAHPS Survey Newsletters and Updates Stay informed with all the latest news and updates occurring at CalOptima Health. Provider Newsletters OneCare Provider Letter Provider Notice Updates Provider Notice Update 189 Provider Notice Update 188 Provider Notice Update 187 Provider Notice Update 186 Provider Notice Update 185 Provider Notice Update 184 Provider Notice Update 183 Provider Notice Update 182 Provider Notice Update 181 View All Ready to Join? Become a CalOptima Health Provider Join the nearly 8,400 health care professionals offering care to Orange County’s most vulnerable residents. Register to join the CalOptima Health Community Network or the CalOptima Health Behavioral Health Network. Get Started Health and wellness Equity and Community Health No-cost wellness services are provided in all threshold languages in person, by phone or in a group session. To refer a member, please complete a Health and Wellness Referral Form .  Find other resources below: Maternal Health Services Health and wellness materials for members Interactive self-management tools for members Cancer screening and support information   Integrated Services Mindful Care Behavioral Health Explore tools for providing behavioral health services to our members. General Resources Frequently Asked Questions SABIRT Resources Common Behavioral Health Forms Autism Resources ACEs Resources Elder Care Long-Term Services and Supports CalOptima Health has offered a long-term care (LTC) benefit for members since 1998. Learn more about our program for providing care to members entering and leaving LTC facilities. Community-Based Adult Services Contracted LTC Facilities LTC and Hospice Provider Forms Multipurpose Senior Services Program (MSSP) Hospice Notification Form (HNF) MEDICATIONS Pharmacy Services CalOptima Health’s Pharmacy Management department supports each of our programs. Medi-Cal Pharmacy Resources OneCare Pharmacy Resources Pharmacy and Therapeutics Committee Changes Pharmacy Residency Program Pharmacy Updates Report Fraud or Abuse Compliance and Ethics Hotline: (855) 507-1805 If you see any activity that you think is fraud or waste, we strongly encourage you to call our Compliance and Ethics Hotline at (855) 507-1805 . You can also report it by using CalOptima Health’s Suspected Fraud or Abuse Referral form. You do not have to give your name to report fraudulent activity. Download the Suspected Fraud or Abuse form The confidential document includes instructions on how to fill it out and where to send it. Provider Events CalOptima Health strives to ensure that our contracted providers are aware of the latest industry best practices, CalOptima Health policies and state regulations. Here you can find upcoming continuing medical education (CME), CalOptima Health Community Network (CHCN) and Lunch & Learn trainings, as well as other provider-focused events. Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map Contact Us Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Contact CalOptima Health Loading component... Loading component... Loading component... Call Us Members (toll-free) Medi-Cal Customer Service Department 1-888-587-8088 OneCare Customer Service Department  1-877-412-2734 Behavioral Health Line 1-855-877-3885 711 TTY Business General 1-714-246-8400   Claims 1-714-246-8600 Provider Resource Line 1-714-246-8600 711 TTY PACE Members and Business PACE Customer Service Department 1-714-468-1100  PACE Enrollment Line 1-844-999-PACE ( 1-844-999-7223 )  1-714-468-1063 TTY Plan Your Visit Customer Service Our Address CalOptima Health 500 City Parkway West Orange, CA 92868 Hours 8 a.m. to 5 p.m., Monday through Friday except for certain holidays Parking Our members and other visitors may park in designated “Visitor” spots or any unmarked spot in the CalOptima Health building parking lot off City Parkway West. Corporate Office Our Address CalOptima Health 505 City Parkway West Orange, CA 92868 Hours 8 a.m. to 5 p.m., Monday through Friday, except for certain holidays Parking Our members and other visitors may park in designated “Visitor” spots or any unmarked spot in the CalOptima Health building parking lot off City Parkway West. PACE Our Address CalOptima Health PACE Center 13300 Garden Grove Blvd. Garden Grove, CA 92843 Hours 8 a.m. to 4:30 p.m., Monday through Friday, except for certain holidays Parking Visitors may park in designated “Visitor” spots or any unmarked spot. Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe website. Health and Wellness Member Health Rewards Programs and Services Self-Care Guides Interactive Tools Additional Resources About Medi-Cal Benefits and Services Mental Health Community Supports Other Programs How to Apply Your Rights About OneCare About OneCare How to Enroll Benefits and Services Pharmacy Your Rights Disclaimers About PACE About PACE Our PACE Center How to Enroll Benefits and Services Your Rights About CalOptima Health About Us Board and Leadership Transparency and Finance Compliance Health Care Fraud News and Media Press Releases Medi-Cal Customer Service 1-888-587-8088 © 2026 CalOptima Health, A Public Agency Notices of Nondiscrimination Notice of Privacy Practices Website Privacy Policy Compliance Information Report Fraud and Abuse Site Map Health and Wellness Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Health and Wellness CalOptima Health offers many services to help members improve or maintain their health. Let us know how we can assist you by calling 1-888-587-8088 (TTY 711 ) or contact us through the Member Portal .  Menu Loading component... HEALTH AND WELLNESS Visit CalOptima Health’s New HealthHub! Check out our new HealthHub for helpful information: Easy-to-read content and videos on common health topics Health and wellness information reviewed by doctors and experts Tools to check your health risks or make a care plan Visit HealthHub Programs and Services Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Health and Wellness Member Health Rewards Take an active role in your health! CalOptima Health offers rewards to eligible members for completing important preventive screenings, tests or exams. Member Health Rewards Call 1-888-587-8088 CalOptima Health members can get health and wellness services at no cost. Support is offered through one-on-one coaching, group classes and mailed health education materials. Call us at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Asthma Nutrition Cholesterol Preventive Screenings Diabetes Pregnancy Heart Disease Tobacco Cessation High Blood Pressure Other Conditions Maternity Health Program Call 1-888-587-8088 Our maternal health program can help you have healthy pregnancy and a strong start for your baby after they’re born. The program  teaches about: Prenatal care Healthy eating Prenatal screening Vaccines Postpartum checkup and care Infant appointments Breastfeeding Resources All Maternal Health services are provided at no cost to CalOptima Health members. Questions? Call CalOptima Health Customer Service toll-free at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language.  Learn more about maternal health services Weight Management Program Call 1-888-587-8088 Weight management helps improve overall health, and we want to support you on this journey. Talk to a member of our Health and Wellness staff over the phone to get the services right for you. Our services include telephonic and face-to-face coaching. If you enjoy learning in a group setting, we provide community education classes throughout Orange County. Call us at 1-888-587-8088 (TTY 711 ). Self-Care Guides Advance Directives Write your wishes about the type of care you would want or do not want, if you become unable to make medical decisions for yourself. Advance Directives: What You Need to Know Advanced Health Care Directive Form CalOptima Health Advance Care Planning Asthma Management Asthma is a chronic disease of the lungs that affects the airways and your breathing. Asthma Triggers Asthma Action Plan Cancer The best way to prevent cancer or to stop it from growing is to get tested. Recommended Cancer Screenings Get Screened for Colorectal Cancer Diabetes Management Diabetes is a disease that affects how your body uses glucose (sugar). What Is a Statin? Tests and Shots for People With Diabetes Fitness Choose activities that you enjoy, such as tending your garden, dancing, bowling or walking your dog. Tips to Increase Your Steps High Blood Pressure High blood pressure makes your heart work harder and increases your risk of having problems like a heart attack or stroke. Understanding High Blood Pressure Immunizations Immunizations are an important part of health care and given to protect health. They prevent diseases and illnesses. Vaccines by Age Injury Prevention Injuries affect people of all ages, from infants to older adults, but can be prevented. Home Safety Tips to Prevent Falls Medication There are risks and benefits to all medicines. Ask your health care team if you do not understand how to take your medicines. Keep Track of Your Medicines Using a Pillbox Make Your Medicine List for Pillbox Mental Health Mental illness is more common than you think. Talk to your doctor about treatment options. Understanding Depression Nutrition Eating fruits and vegetables every day reduces the risk of cancer, heart disease and other illnesses. A Handy Guide to Picture Your Portions Tips For Eating Out Pregnancy / Postpartum Those who have early and constant prenatal care have babies with better health. Well-Child Visits: When to Go and What to Expect Tobacco Cessation After you quit smoking, your body will start to feel better inside and out! These good changes will carry on for years. Quit Smoking: How To Work Through It What You Can Do When the Craving Starts Wellness Are you new to CalOptima Health? Call your doctor today to schedule your first visit within 90 days. Adult Health Checklist Interactive Self-Management Tools Call 1-888-587-8088 Take any of the quizzes below at no cost to see where you are on different health issues and learn about changes that may improve your health. For more information about CalOptima Health’s health education programs and services, call us at 1-888-587-8088 (TTY 711 ), Monday–Friday, from 8 a.m.–5:30 p.m. We have staff who speak your language. Help and Resources in Orange County OC Navigator Resources Kids Builders by First 5 OC 211OC Resources Families and Community Together OC Avoiding At-Risk Drinking Evaluate your alcohol intake Healthy Eating Take the nutrition and activity quiz How many calories do you consume? How much fruit, vegetable, and fiber do you need? Heart Health Take the healthy heart quiz Healthy Weight (BMI) Maintenance Calculate your body mass index (BMI) Identifying Depression Symptoms Take a depression screening Take a mental health test Think you might be depressed? Take the quiz to find out if you are showing signs of depression Managing Stress Learn to manage your stress Physical Activity Use the body weight planner to balance your food and activity Smoking and Tobacco Use Cessation Take the nicotine addiction quiz Take the Smoking Habits Quiz Additional Resources MyHealthfinder Tool The contents of this website are for informational purposes only. This information should not be used to diagnose or treat any illness or injury and does not replace advice from your physician or other qualified medical personnel. The contents of this site are for your personal use and should not be used to provide advice to others. Always seek the advice of medical personnel with any questions or concerns you have regarding any medical conditions. Never disregard medical advice from qualified personnel because of something you read on the CalOptima Health website or any website link provided to you on the CalOptima Health website. In the event of a medical emergency, visit your nearest emergency room or call 9-1-1 . CalOptima Health makes no guarantee about the accuracy or completeness of the information provided on this website. By using this website, you agree that any actions you take regarding the information provided are taken at your own risk and are not the responsibility of CalOptima Health. Additional Resources Previous Next PREVENTIVE CARE Cancer Screenings Explore Cancer Resources MORE BENEFITS California Advancing and Innovating Medi-Cal (CalAIM) Learn About CalAIM MENTAL HEALTH Mental Health Services Discover Our Mental Health Services SUPPORTIVE CARE Gender Affirming Care Learn About Transgender Health and Gender-Affirming Care Materials available on this website in PDF format may require the free Adobe Reader to view. Download Adobe Reader for free from the Adobe Website Privacy Policy Skip to Main Content Search New! Check out HealthHub for helpful information and tools at any time of the day. Website Privacy Policy INTRODUCTION Date of Last Revision: July 29, 2025 This website privacy policy (“Privacy Policy”) explains how Orange County Health Authority, a California local public agency doing business as CalOptima Health (hereinafter also referred to as “we,” “us” or “our”), collects information and what type of information is collected from users (hereinafter referred to as “user,” “you” or “your”) by any or all CalOptima Health websites, webpages, and landing pages, including without limitation:  Those with the uniform resource locator (URL) address: www.caloptima.org. Those that relate in any way to the CalOptima Health member portal. All other websites, webpages and landing pages owned and/or operated by CalOptima Health or hosted and/or operated by third parties on our behalf. The websites described above are collectively hereinafter referred to as “CalOptima Health’s Websites” (unless otherwise specified). In addition to explaining how CalOptima Health collects information, this Privacy Policy also describes how CalOptima Health stores, uses, protects, and discloses information collected on CalOptima Health’s Websites. The information provided on CalOptima Health’s Websites is not a substitute for the advice of a personal physician or other qualified health care professional. Always seek the advice of a physician or other qualified health care professional with any questions regarding medical symptoms or a medical condition. Before accessing, visiting and/or using CalOptima Health’s Websites and/or providing CalOptima Health with any such information as described in the Privacy Policy, you acknowledge that you have read, understood and agreed to all terms and conditions set forth in the Privacy Policy. CalOptima Health reserves the right at any time in our sole discretion to modify or change the Privacy Policy. As applicable, your use of CalOptima Health’s Websites may be subject to the Notice of Privacy Practices ( NPP ). The NPP describes how CalOptima Health uses and discloses your protected health information. If you do not agree to the terms and conditions in this Privacy Policy or the NPP please do not use CalOptima Health’s Websites. Your continued use of this website constitutes your acceptance of the terms and conditions.  Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... Loading component... USE OF LICENSED OR COPYRIGHTED MATERIAL The downloading, republication, retransmission, reproduction or other use of images, videos, fonts, and other licensed or copyrighted material from this website as standalone files is prohibited. The people in the licensed photos and videos that appear on this website are models and used for illustrative purposes only. Loading component... Loading component... Loading component... Loading component... Sections How CalOptima Collects Information The Type of Information About You that CalOptima Collects Where CalOptima Stores Information About You How CalOptima Uses Information About You How CalOptima Discloses Information About You How CalOptima Protects Information About You How CalOptima Responds to “Do Not Track” Signals Our Policy Toward Children Privacy Policies of Linked Sites Modifications or Changes to Our Privacy Policy Use of Licensed or Copyrighted Material The Process for Reviewing and Requesting Changes to Personal Information About You that CalOptima Stores Your Written Authorization Rights Access Rights and Complaints HOW CALOPTIMA COLLECTS INFORMATION A. www.caloptima.org CalOptima Health may automatically collect certain information about you through your access to and/or use of www.caloptima.org. CalOptima Health may place “cookies” and/or other types of files and/or software code on the computer or other device that you use to access www.caloptima.o