CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES
Health Care Options, P.O. Box 989009
West Sacramento, CA 95798-9860
To the addressee or guardian of:
270IMC010031C-0000001-19-7-M-M
Choose A Plan
See inside for
choice forms
IMC999999999-02/26/15
JOHN SAMPLE
1234 SAMPLE STREET
ANYTOWN CA 90000
Managed Care Plan
Choice Book
Cal MediConnect and Medi-Cal
Managed Care Plans
IMC
Department of Health Care Services
MU_0004052_ENG_0916
Los Angeles County
Cal MediConnect
These plans cover both Medicare and Medi-Cal. You can choose one of these
Cal MediConnect plans under Choice A on the Plan Choice Form.
Care1st Cal MediConnect Plan
1-855-905-3825 • (TTY: 711)
care1st.com/ca/calmediconnect
L.A. Care
1-888-522-1298 • (TTY: 711)
calmediconnectla.org
Health Net Cal MediConnect
1-888-788-5395 • (TTY: 711)
healthnet.com/calmediconnect
Molina Dual Options
1-855-665-4627 • (TTY: 711)
molinahealthcare.com/duals
Medi-Cal Managed Care
These plans cover only Medi-Cal. If you want to keep your Medicare the way it is now, choose
one of the Medi-Cal plans under Choice B on the Plan Choice Form.
Health Net Comm Solutions
L.A. Care Health Plan
Molina Health Plan
1-888-665-4621• (TTY: 1-800-479-3310)
molinahealthcare.com
Care1st Health Plan
1-800-605-2556 • (TTY: 1-800-735-2929)
care1st.com
Plan Partners
Health Net
1-800-327-0502 • (TTY: 1-800-431-0964)
healthnet.com
Plan Partners
Anthem Blue Cross
1-800-407-4627 • (TTY: 1-888-757-6034)
anthem.com
Kaiser Permanente
1-800-464-4000 • (TTY: 1-800-777-1370)
healthy.kaiserpermanente.org
L.A. Care
1-888-839-9909 • (TTY: 1-866-522-2731)
lacare.org
Call the health plans to ask if they work with your doctors and other health care
providers. You may also ask for a list of doctors and providers that they work with.
Program of All-Inclusive Care for the Elderly (PACE)
These plans cover both Medicare and Medi-Cal. If you qualify for PACE, services are
provided in a PACE center. You must still choose a Cal MediConnect plan in Choice A OR a
Medi-Cal plan in Choice B listed on your choice form. While we are checking your eligibility
for PACE, you will not be enrolled in Cal MediConnect or a Medi-Cal Managed Care plan.
We will need to know your choice just in case you do not qualify for PACE.
Altamed Senior BuenaCare
Toll Free: 1-877-462-2582
(TTY: 1-800-735-2922)
altamed.org/seniorservices
Brandman Centers for Senior Care
Toll Free: 1-855-774-8444
(TTY: 1-818-774-3194)
brandmanseniorcare.org
LA_0004089_ENG_0916
State of California-Health and Human Services Agency
Department of Health Care Services
P.O. Box 989009, West Sacramento, CA 95798-9850
February 26, 2015
To the addressee or guardian of:
u IMC - *999999999IMC022615*
t
IMC-999999999-02/26/15
JOHN SAMPLE
1234 SAMPLE STREET
SAMPLE CITY CA 99999
You are getting this letter because you are eligible for BOTH Medicare and Medi-Cal. You
must choose a health plan for your Medi-Cal benefits (including Long-Term Services and
Supports). You have many health plans to choose from to receive your Medi-Cal benefits.
You can choose a Cal MediConnect plan, which covers all of your Medicare and Medi-Cal
benefits together under one plan, and includes extra benefits. You can also choose to keep
your Medicare separate and choose a Medi-Cal Managed Care plan for your Medi-Cal
benefits. You also may be eligible to apply for a Program of All-Inclusive Care for the Elderly
(PACE) plan, if you are over 55 and meet certain requirements.
This choice book explains the benefits of each health plan and explains how to enroll into
the plan that best fits your health care needs. Please read the choice book carefully.
You have the following choices:
• Join a Cal MediConnect Plan.
Cal MediConnect combines all your Medicare and Medi-Cal benefits into one, convenient
health plan. Cal MediConnect is only available in certain counties. If you move, contact
your eligibility worker to learn about your options.
• Join a Medi-Cal Managed Care Plan.
You can choose to keep your Medicare and Medi-Cal separate, but you must still join a
Medi-Cal Managed Care plan for your Medi-Cal benefits. Joining a Medi-Cal Managed
Care plan will not change your Medicare benefits.
If eligible, you may also apply for Program for All-Inclusive Care for the Elderly (PACE).
PACE plans cover all Medicare and Medi-Cal benefits. Services are provided at PACE
centers and at home. You must qualify for PACE. If you choose PACE, you must still select
a Cal MediConnect or Medi-Cal Managed Care plan in case you do not qualify for PACE.
Enclosed in this choice book is your health plan enrollment choice form, please complete
and return the choice form by 4/24/2015.
MU_IA04051_ENG1_0916
270IMC010031C-000003-19-7-M-M
If you do not make a choice, we will choose a Medi-Cal Managed Care plan for you.
You can choose a plan that fits your needs at any time before 4/24/2015.
After we receive your plan choice, you will receive a letter with your chosen health plan’s
name and start date for your coverage. Your new health plan will also send you helpful
information about how to get the care you need once you are enrolled. You can change
your health plan at anytime by contacting Health Care Options toll-free at 1-844-580-7272.
The effective date of your plan enrollment will depend on when we receive your plan
choice but it wont be later than 5/1/2015.
Your plan could be effective as early as the first of next month.
If you have questions, want to enroll over the phone, need this packet in another language
or alternative format, please call Health Care Options toll-free at 1-844-580-7272, between
the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday. TTY/TDD users please call
1-800-430-7077.
If you need help completing the choice form, please see the Health Care Options
presentation schedule inside this choice book for site locations near you or visit us online
at healthcareoptions.dhcs.ca.gov.
If you’d like more information on the specific benefits offered by each health plan, please
contact the health plan directly. Health plan contact information is located in the front of
this choice book. You can also call the Health Insurance Counseling and Advocacy Program
(HICAP) at 1-800-434-0222. HICAP provides free and objective counseling and can help
you understand your plan options and assist in filling out the forms in this choice book.
We look forward to working with you to keep you healthy.
MU_IA04051_ENG2_0916
What are my choices?
You must choose one of these options. Your choices are listed below. There is no
cost to join a health plan.
Choice A: Enroll in a Cal Medi-Connect plan. This plan:
• Combines all of the Medicare and Medi-Cal
benefits and services you receive now into a
single plan with added benefits.
• Gives additional transportation to medical
services and vision benefits.
• Gives you a Care Coordinator to help
you with your health care needs. A Care
Coordinator will be assigned to you when
you join a Cal MediConnect plan.
• Ensures Cal MediConnect doctors,
specialists, and other approved providers
will work together to get you the care you
need.
Choice B: Stay with regular Medicare AND enroll in
a Medi-Cal Managed Care plan for your
Medi-Cal benefits.
• If you choose to stay with regular
Medicare, you MUST ALSO choose a
Medi-Cal Managed Care plan to receive
your Medi-Cal benefits.
• If you are already in a Medi-Cal
Managed Care plan and choose to stay
in regular Medicare, you can choose
to stay in that Medi-Cal Managed Care
plan or choose a different Medi-Cal
Managed Care plan.
What if I don’t choose a Health Plan?
If you do NOT make a choice, you will be automatically enrolled in the Medi-Cal Managed
Care plan that we have chosen for you.
MU_0004071_ENG_0916
How to Make a Health Plan Choice
There are several ways you can make a health plan choice.
Call Toll Free by 4/30/2015
• Health Care Options toll free at 1-844-580-7272, Monday
through Friday, 8:00 a.m. to 5:00 p.m. For TTY users, call
1-800-430-7077.
OR
Visit Health Care Options in Person
You can visit a Health Care Options presentation site and speak
to someone in person. To find the nearest location see the
enclosed presentation schedule or contact Health Care Options:
–– 1-844-580-7272 for more information.
For TTY users, call 1-800-430-7077.
–– Visit www.healthcareoptions.dhcs.ca.gov and click
“Presentation Sites” link.
OR
Mail In Your Health Plan Choice Form by 4/24/2015
Complete the Health Plan Choice Form in this book and mail in
the postage paid envelope provided.
GET MORE INFORMATION
For free, in-person counseling, contact the Health Insurance
Counseling and Advocacy Program (HICAP). HICAP provides
free and objective information and counseling on health
plans. Call: 1-800-434-0222 or visit: aging.ca.gov/hicap
MU_0004070_ENG_0916
Health Plan Choice Form Instructions
These instructions will help you fill out the Health Plan Choice Form on the next page to
select the option that works best for you.
For help filling out the form, call Health Care Options at 1-844-580-7272.
STEP 1: Tell us about yourself
Please fill in any blanks and correct any errors on the Health Plan Choice Form. If your name
and other information are correct, you may proceed to Step 2.
STEP 2: Choose a health plan
Please choose a plan. If you do NOT make a choice, you will be automatically enrolled into a
Medi-Cal Managed Care plan.
• Choice A - If you want to get your Medicare and Medi-Cal benefits combined in one
plan, fill in the circle ( ) to the left of the Cal MediConnect plan you want.
• Choice B - If you want to keep your Medicare separate from your Medi-Cal, you must
choose a Medi-Cal plan for your Medi-Cal benefits. Fill in the circle ( ) to the left of the
Medi-Cal plan you want.
If you’d like to get your Medicare and Medi-Cal benefits combined in one plan and receive
care at dedicated PACE centers, fill in the circle for the PACE plan you want. In case you do
not qualify, you MUST still choose a plan in Choice A or Choice B.
• To qualify for the Program of All-Inclusive Care for the Elderly (PACE), you have to meet
certain requirements such as:
• Be age 55 or older,
• Live in a zip code served by a PACE organization
• Be able to live in your home and community safely, and
• Meet a level of need for skilled nursing home care, as determined by the PACE
organization’s interdisciplinary team assessment and certified by the Department of
Health Care Services.
Ask your doctors and other health care providers to see which plans they work with and check
if your prescription drugs are covered. You may also contact the plans directly to get a list of
doctors and providers. Telephone numbers for the plans are listed in the front page of this
choice book.
Fill in the Doctor/Clinic Codes - Optional (if known)
Doctor/Clinic Codes can be found by asking your Doctor/Clinic or in the Health Plan Provider
Directory located at: http://www.dhcs.ca.gov/services/Pages/MMCDProvInfoNet.aspx
STEP 3: Read the important information on the back before signing.
Please read the information on the back of the form, then sign and date your completed
Health Plan Choice Form. Use the envelope in this Choice Book to mail your completed
Health Plan Choice Form. You do not need a stamp if you use the enclosed envelope.
MU_PCE4062_ENG_0916
Health Plan Choice Form
California Department of
Health Care Services
P.O. Box 989009
W. Sacramento, CA 95798-9850
*CCIPB*
Use this form to join or change a health plan. For FREE help with this form, contact Health Care Options at
1-844-580-7272. Mail completed form to California Department of Health Care Services, Health Care Options,
P.O. Box 989009, West Sacramento, CA 95798-9850. Please print clearly using blue or black ink.
99999
U
SE
STEP 1: Tell us about yourself:
CCIPB
Zip Code
Date of Birth
JOHN SAMPLE
-
-
*M-0-999999999-IMC*
Social Security Number
___ ___ ___ ___ ___ ___ ___ ___ ___
First Name, Last Name
M-0-999999999-IMC
Address, City
(___ ___ ___) ___ ___ ___ -___ ___ ___ ___ Sex: Male
Female
Month STEP 2: Choose your health plan:
OR
Day CHOICE B
Keep my Medicare separate AND choose a
Medi-Cal Managed Care plan.
Choose one of these Cal MediConnect plans:
Choose one of these Medi-Cal Managed Care
plans to get your Medi-Cal benefits:
FO
R
304
T
L.A. Care
Health Net
Molina Dual Options
Care1st
O
Combine my Medicare and Medi-Cal benefits in
one plan.
800
801
816
817
L.A. Care Health Plan
Plan Partners
CF
KA
LA
BC
352
Care1st Partner Plan, LLC
KP Cal, LLC
L.A. Care Health Plan
Anthem Blue Cross Partnrshp
Health Net Comm Solutions
N
O
Plan Partners
HN Health Net Comm Solutions
MO Molina Healthcare Partner
E
PL
Doctor/Clinic Code:
Year
FF
I
CHOICE A
-
If pregnant, estimate due date ___ ___-___ ___-___ ___
C
IA
(Area Code) Phone Number
-
___ ___ ___ ___ ___ ___
L
1234 SAMPLE STREET SAMPLE CITY
Doctor/Clinic Code:
(optional)
PACE Plan:
052
060
AltaMed Senior BuenaCare
Brandman Cent for Sen Care
SA
M
Program of the All-Inclusive Care for the Elderly (PACE):
You may qualify for PACE (see instructions). If you want to get
your Medicare and Medi-Cal benefits combined in a PACE plan,
fill out this option in addition to Choice A or B.
(optional)
If you do not qualify, you will get your care through the
Choice A or Choice B plan that you chose above in Step 2.
STEP 3: Read the important information on the back before signing. I understand that by filling out and signing this
form, I am choosing how to get my health care.
Applicant’s Signature
*CCIPB*
CCIPB
Date
OR
Authorized Representative Signature (if any) Date
Confidential
MU_0004073_ENG1_0916
Health Plan Choice Form
California Department of
Health Care Services
P.O. Box 989009
W. Sacramento, CA 95798-9850
Read this important information before you sign the form.
If I join the Medi-Cal KP Cal, LLC (Kaiser Permanente):
I understand that Kaiser requires binding arbitration for
my Medi-Cal benefits. This means that I give up my right
to a jury or court trial for medical malpractice and other
disagreements about benefits and services. Instead,
I would help choose independent professionals who
would make a decision about the problem. I can still ask
for a Medi-Cal State Hearing.
If I choose PACE, I will be contacted to see if I meet the
eligibility requirements for enrollment into the PACE
health plan. I must meet the nursing home level of care
and still be able to live safely in a community setting.
By completing this enrollment application for a Cal
MediConnect plan, I agree to the following:
Cal MediConnect plans are Medicare-Medicaid plans
that have a contract with the State of California and the
Federal government. I will need to keep my Medicare
Parts A, B and D and Medi-Cal. I can be in only one
Medicare plan at a time, and I understand that my
enrollment in the plan selected will automatically end
my enrollment in any other Medicare health plan or
Medicare prescription drug plan.
I understand that prescription drugs are covered,
but not always the same ones I’m already taking. I
understand that I’ll be able to receive at least one 30day supply of the prescription drugs I currently take
anytime during the first 90 days of coverage in a Cal
MediConnect plan. I understand that I may be able to
continue seeing the doctors I go to now for a period
up to six (6) months for Medicare services and a period
of up to twelve (12) months for Medi-Cal services from
the effective date of enrollment in a Cal MediConnect
plan. I must contact the Cal MediConnect plan for
information on how to do this. My provider must be
willing to work with my plan and/or accept payment.
I further understand that the Cal MediConnect plan
has providers and pharmacies that I must use to
get health care services, except for non-routine,
emergency situations.
Cal MediConnect plans serve a specific service area. If
I move out of the area covered by the plan chosen, I
need to notify the plan so I can disenroll and find a new
plan in my new area.
I understand that beginning on the date my Cal
MediConnect coverage begins, I must get all of my
health care from my new plan, except for emergency
or urgently needed services or out-of-area dialysis
services. Services authorized by my Cal MediConnect
plan and other services contained in my plan's Evidence
of Coverage document will be covered. Without
authorization, NEITHER Medicare, Medi-Cal NOR my Cal
MediConnect plan WILL PAY FOR THE SERVICES.
Release of Information: By joining this Medicare and
Medicaid plan or PACE, I acknowledge that the plan I
selected will release my information to Medicare and
other plans as is necessary for treatment, payment
and health care operations. I also acknowledge that
my Cal MediConnect plan will release my information,
including my prescription drug event data, to Medicare,
who may release it for research and other purposes
which follow all applicable Federal statutes and
regulations. The information on this enrollment form is
correct to the best of my knowledge. I understand that
if I intentionally provide false information on this form, I
will be disenrolled from the plan.
I understand that my signature (or the signature of
the person authorized to act on my behalf under the
laws of California on this application) means that I've
read and understand the contents of this application.
If signed by an authorized individual, this signature
certifies: 1) this person is authorized under State law to
complete this enrollment and 2) documentation of this
authority is available upon request from Medicare.
Privacy Statement
The Department of Health Care Services will keep the information you provide. It is used only to enroll and/
or disenroll people that are eligible for Medi-Cal managed care. The laws that allow this are in the Welfare and
Institutions Code, Section 10416.5, 14016.6, 14087.305, 14087.31, 14087.35, 14087.36, 14087.38, 14087.96,
14088, 14089, 14089.5, and 14631, and California Code of Regulations, Section 51085.5.
Only other government agencies that relate to the Medi-Cal program can see the information you provide.
However, any information that is being used in an investigation or lawsuit cannot be seen. If you want to see
your Medi-Cal file, contact the Department of Health Care Services at the address on the other side of this form.
MU_0004073_ENG2_0916
Health Information Form
You are receiving this form because you are
eligible to enroll in a new Medi-Cal health plan. Your
new plan will use this form to make sure you get
needed care.
Please fill in the circle with black or blue pen
for the answers that apply to you. Complete
one form for each person in your family who is
enrolling in a new Medi-Cal health plan.
If you have questions, please call Health Care
*1010*
1010
Options, toll free at 1-800-430-4263 Monday
through Friday, between 8:00 a.m. and 5:00 p.m. TDD/TTY users should dial 1-800-430-7077.
Please return completed form with your
Medi-Cal Choice Form or mail separately to:
CA Department of Health Care Services
Health Care Options - PO Box 989009
West Sacramento, CA 95798-9850
Filling out this form is voluntary. You will not be denied care based on your confidential answers.
JOHN
SAMPLE
*999999999-999999999*
*999999999-999999999*
Born In: 2016
999999999 - 999999999
Name of Person Completing Form:
Yes No
2. Do you take 3 or more prescription medicines each day?. . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
3. Do you see a doctor regularly for a mental health condition such
as depression, bipolar disorder, or schizophrenia? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
4. Have you been to the emergency room two or more times in the
last 12 months? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes 5. Have you been admitted to the hospital in the last 12 months?. . . . . . . . . . . . . . . . . . . . . Yes No
No
6. Have you needed help with personal care, such as bathing, getting
dressed, or changing bandages in the last 6 months? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes 7. Are you using medical equipment or supplies, such as a hospital bed,
wheelchair, walker, oxygen, or ostomy bags? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes 8. Do you have a condition that limits your activities or what you can do?. . . . . . . . . . . . . . . . . Yes 9. Are you pregnant?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a. If Yes, are you currently seeing a doctor for this pregnancy? . . . . . . . . . . . . . . . . . . . . . . Yes Yes 10.Do you see a doctor regularly for a chronic medical condition? . . . . . . . . . . . . . . . . . . . . . . . Yes No
No
No
No
No
IM
A
MI GE
SS
IN
G
1. Do you need to see a doctor within the next 60 days? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If Yes, fill in all that apply:
No
Asthma
Cancer
Cystic Fibrosis
Diabetes
Kidney Disease
Seizures
Sickle Cell Anemia
Tuberculosis
Heart Problems
Hepatitis
High Blood Pressure
HIV or AIDS
Other
When you become a health plan member,
If you think you need to see a doctor before your
DHCS will send this information to your Medi-Cal
Medi-Cal health plan contacts you, you should go to
health plan.
the doctor or hospital at that time.
I understand that this information will be disclosed to Health Care Options and my new plan.
Signature:
Date Signed:
If not signed by beneficiary, specify relationship: . Parent of minor
CONFIDENTIAL
Guardian .Other representative
MU_0003754_ENG_0912
State of California - Health and Human Services Agency
Department of Health Care Services
Medi-Cal Managed Care
Non-Medical Exemption
Request for Non-Medical Exemption from Plan Enrollment
American Indians or Beneficiaries with HIV/AIDS in Coordinated Care Initiative Counties
Dear Medi-Cal Beneficiary: If you are receiving Medi-Cal
benefits, you may be required to join a Medi-Cal Managed
Care health plan. However, if you are a qualified individual
for this exemption and you want to receive medical services
through your choice of facility or provider, you may request
to be excused from Medi-Cal Managed Care health plan
enrollment in order to receive services through a service
facility or provider of your choice.
To be excused from plan enrollment you must have a service
facility or provider representative complete this form, certifying
that you are or will be receiving services from a service facility
or provider of your choice. The facility representative must
submit this completed form to Health Care Options.
Dear Service Facility or Provider: If you currently provide
or will be providing medical services to an individual who is
receiving Medi-Cal benefits and that individual is required
to enroll in a health plan, completion of this form will enable
the individual to receive services through your facility as an
alternative to enrollment in a Medi-Cal Managed Care health
plan. The exemption form is valid until the individual chooses
to enroll in a Medi-Cal Managed Care health plan. This form
may be submitted for beneficiaries who are receiving Medi-Cal
services in a Coordinated Care Initiative County and has
operating Cal MediConnect health plans and: 1) are American
Indian, or 2) have been diagnosed with HIV or AIDS.
Mail completed form to:
or Fax this form to:
Health Care Options
(916) 364-0287
P.O. Box 989009
West Sacramento, CA 95798-9850
If you have any questions regarding this form, please call HCO at 1-844-580-7272; TTY/TDD users, call 1-800-430-7077.
Please Print or Type (Ink Only)
Each area of this non-medical exemption form must be completed or the form will be returned unprocessed.
1. Beneficiary Name:
2. Beneficiary Medi-Cal I.D. Number (BIC)
Last Name
First Name M.I.
3. Name of Service Facility or Provider
I certify that the information I have provided on this form is correct. I understand that the Department of Health Care Services may audit this form to
determine if the information provided is accurate.
4a. Authorized Signature of Medi-Cal Provider
4b. Date signed
/ / Month Day
Year
4d. NPI Number used to bill the Medi-Cal Program for this beneficiary
4c. Printed name of Medi-Cal Provider
Last Name
First Name
M.I.
5. Telephone number of Medical Provider
6. Fax number of Medical Provider
( ) - ( ) - 7. Telephone number of Medical Physician
8. Fax number of Medical Physician
( ) - ( ) - MU_CCI3382_ENG_1114
1OZ_0004074_ENG1_0916
1OZ_0004074_ENG2_0916
Do not put more than 4 forms in this envelope
Health Care Options
Presentations
Attend an informative session at one of these convenient locations.
California Health Care Options (HCO) Presentation Sites
Los Angeles County
October 2016 Schedule
Just ask for the
"Health Care Options"
Representative
In-Person Medi-Cal Managed Care Information
No Appointment Necessary
Free Help To Complete Forms
CITY
LOCATION
County of LA Dept of
Public Social Services
Santa Clarita Branch
27233 Camp Plenty Road
County of LA Dept of
Public Social Services
Chatsworth DPSS West Valley Family
Service Center
21415 Plummer Street
Canyon
Country
Compton
Cudahy
El Monte
County of LA Dept of
Public Social Services
211 E. Alondra Boulevard
County of LA Dept of
Public Social Services
8130 S. Atlantic Avenue
County of LA Dept of
Public Social Services San
Gabriel Valley Family
Service Center
3350 Aerojet Avenue
County of LA Dept of
Public Social Services
San Gabriel Valley Family
Service Center
3352 Aerojet Avenue
ZIP
CODE
DAY
HCO SITE HOURS
LANGUAGES
91351
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
91311
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90220
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90201
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Vietnamese /
Cantonese /
Mandarin
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish /
Vietnamese /
Cantonese /
Mandarin
91731
91731
Presentation times, dates, and locations are subject to change. Please contact the Health Care
Options toll-free number 1-844-580-7272 to verify the schedule before attending. Additional sites may be
available at the time of your call. Health Care Options will not be conducting presentations on October
10th due to a staff meeting.
Page 1 of 4
MSM-C-M61
LA_LTSS_PRES_ENG1_1016
Health Care Options
Presentations
Attend an informative session at one of these convenient locations.
California Health Care Options (HCO) Presentation Sites
Los Angeles County
October 2016 Schedule
Just ask for the
"Health Care Options"
Representative
In-Person Medi-Cal Managed Care Information
No Appointment Necessary
Free Help To Complete Forms
CITY
LOCATION
ZIP
CODE
DAY
HCO SITE HOURS
LANGUAGES
English / Spanish
/ Armenian /
Russian / Farsi
Glendale
Los Angeles County Dept
of Public Social Services
4680 San Fernando Road
91204
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
Lancaster
Los Angeles County Dept of
93535
Public Social Services
349-B East Avenue K-6
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Dept of Public Social
Services County of Los
Angeles
5445 Whittier Boulevard
90022
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Exposition Park
Family Service Center
County of Los Angeles
3833 S. Vermont Avenue
90037
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90001
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Los Angeles County Dept of
90032
Public Social Services
4077 N. Mission Road
T&W
8:00am - 12:30pm
1:30pm - 5:00pm
TH
8:00am - 12:30pm
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
Los Angeles County of LA Dept of
Public Social Services
1740 E. Gage Avenue
Dept of Public Social
Services County of LA
2855 E. Olympic Blvd
90023
English / Spanish
English / Spanish
Presentation times, dates, and locations are subject to change. Please contact the Health Care
Options toll-free number 1-844-580-7272 to verify the schedule before attending. Additional sites may be
available at the time of your call. Health Care Options will not be conducting presentations on October
10th due to a staff meeting.
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Health Care Options
Presentations
Attend an informative session at one of these convenient locations.
California Health Care Options (HCO) Presentation Sites
Los Angeles County
October 2016 Schedule
Just ask for the
"Health Care Options"
Representative
In-Person Medi-Cal Managed Care Information
No Appointment Necessary
Free Help To Complete Forms
CITY
ZIP
CODE
DAY
HCO SITE HOURS
LANGUAGES
County of Los Angeles
2615 S. Grand Avenue
90007
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
County of LA Dept of
Public Social Services
2601 Wilshire Boulevard
90057
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Metro Special District #70
2707 S. Grand Avenue
90007
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90064
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90059
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
County of LA
Administration Building
8300 S. Vermont Ave
90044
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
County of LA Dept of
Public Social Services
Southwest Special District
1819 Charlie Sifford Drive
90047
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
LOCATION
Dept of Public Social
Services Rancho Park
District
Los Angeles 11110 W. Pico Blvd
Ben F Peery Building
County of LA Dept of
Public Social Services
10728 S. Central Avenue
Presentation times, dates, and locations are subject to change. Please contact the Health Care
Options toll-free number 1-844-580-7272 to verify the schedule before attending. Additional sites may be
available at the time of your call. Health Care Options will not be conducting presentations on October
10th due to a staff meeting.
Page 3 of 4
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Health Care Options
Presentations
Attend an informative session at one of these convenient locations.
California Health Care Options (HCO) Presentation Sites
Los Angeles County
October 2016 Schedule
Just ask for the
"Health Care Options"
Representative
In-Person Medi-Cal Managed Care Information
No Appointment Necessary
Free Help To Complete Forms
CITY
LOCATION
Dept of Public Social
Los Angeles Services County of LA
2415 W. 6th Street
Norwalk
Pasadena
Pomona
Rancho
Dominguez
Van Nuys
Norwalk
12727 Norwalk Blvd.
LA County Dept of Public
Social Services Child
Support Services
955 N. Lake Avenue
LA County Dept of Public
Social Services
2040 W. Holt Avenue
County of LA Dept of
Public Social Services
Paramount District Office
2961 East Victoria Street
ZIP
CODE
DAY
HCO SITE HOURS
LANGUAGES
90057
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90650
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
91104
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
91768
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
90221
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
County of LA Dept of
Public Social Services
17600 "A" Santa Fe Ave.
90221
Zev Yaroslavsky Family
Support Center
7555 Van Nuys Blvd.
91405
M-F
T & TH
M-F
8:00am - 12:30pm
1:30pm - 5:00pm
8:00am - 12:30pm
1:30pm - 5:00pm
English / Spanish
Cambodian
English / Spanish
Presentation times, dates, and locations are subject to change. Please contact the Health Care
Options toll-free number 1-844-580-7272 to verify the schedule before attending. Additional sites may be
available at the time of your call. Health Care Options will not be conducting presentations on October
10th due to a staff meeting.
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If you or your family members have any questions, call
Health Care Options, toll-free at the numbers listed below:
Representatives are available Monday – Friday 8:00 a.m. to 5:00 p.m.
English
1-844-580-7272
Written materials are available
‫اللغة العربية‬
Arabic
1-844-580-7272
‫تتوفر معلومات مطبوعة‬
Հայերեն
Armenian
1-844-580-7272
Գրավոր նյութեր գոյություն ունեն
ភាសា​ខ្មែរ
Cambodian
1-844-580-7272
មាន​ផ្ដលឯ
់​ កសារ​សរសសរ​ជា​លាយលក្ខណ៍​អក្សរ
粵語
Cantonese
1-844-580-7272
可以提供書面材料
‫فارسی‬
Farsi
1-844-580-7272
:‫مطالب به زبان های زیر موجود است‬
Hmoob
Hmong
1-844-580-7272
Cov lus uas sau hauv ntawv los
muaj thiab
한국어
Korean
1-844-580-7272
서면 자료의 이용이 가능합니다
國語
Mandarin
1-844-580-7272
可以提供書面材料
Español
Spanish
1-844-580-7272
Se dispone de material escrito
Tagalog
Tagalog
1-844-580-7272
May mga nakasulat na materyales
Tiếng Việt
Vietnamese
1-844-580-7272
Có các tài liệu dưới dạng văn bản
Other Languages
1-844-580-7272
TTY
1-800-430-7077
Русский
Russian
1-844-580-7272
Доступны материалы в
письменном виде
MU_0004052_LANG2_0916