Other Coverage
Other Coverage is responsible for the identification of all health insurance belonging to Medi-Cal beneficiaries as well as maintaining the automated Health Insurance System.
Other Coverage identifies health insurance resources through referrals from county offices and the Social Security Administration. This information is also obtained by conducting data exchanges with various health insurance companies. When the health insurance information is received, our system is updated to ensure that Medi-Cal is the payer of last resort.
Individuals requesting updates to the other health coverage (OHC) should either use the OHC Processing Center, contact TPLRD via secure email, fax, or request their county eligibility worker to send the secure request. As a reminder, all requests for OHC that contain personally identifiable information sent to the WATS email box at WATS@dhcs.ca.gov must be secured with an email encryption program. Counties should use the OHC Processing Center or refer to Section VI-E of their Medi-Cal Data Privacy and Security Agreements for secure email requirements. If you cannot use the OHC Processing Center link or send a secure email, you may submit your request via fax to (916) 440-5675. Please allow at least 96 hours for your request to be processed. Counties who send OHC termination information are not required to send termination verification letters.
Please note that OHC staff cannot make changes to Healthly Families records. Requests regarding erroneous Healthy Families coverage indicators need to be directed to CWD Liaisons / HFPMeds@maximus.com / 916-673-4602.
New! Welcome to the OHC Processing Center that allows you to update commercial health insurance and to a limited extent - Medicare plans for Medi-Cal beneficiaries. We strongly encourage county offices, as well as individuals, to take advantage of this online form, when requesting changes to OHC indicators. The OHC Processing Center provides a secure means of transmitting minimum Personal Health Information required to process your request.
OHC Processing Center Forms
To add OHC: OHC Additions
To remove OHC: OHC Removals