Medicare Advantage Plans
Cov txheej txheem ntawv pov thawj (yeem yeem txhim kho)
Lub hom phiaj
Muab ib daim ntawv qhia txog lub county Mental Health Plans (MHPs) xa cov ntaub ntawv thov rau Medi-Cal cov nyiaj them rov qab rau Short-Doyle/Medi-Cal (SDMC) cov nyiaj them rov qab tshwj xeeb rau cov kev pab cuam puas siab puas ntsws muab rau cov neeg tau txais txiaj ntsig tsim nyog rau ob qho tib si Medicare thiab Medi-Cal (dual tsim nyog tau txais Mediage) uas nws tau txais kev pab them nqi kho mob los ntawm Mediage. Medicare Risk HMO or Medicare Part C plan).
Cov ntaub ntawv
INFORMATION CEEB TOOM 09-09, 10-11, 10-23, 11-06, thiab 13-24
Txheej txheem txheej txheem
Yog tias tsim nyog ob qho tib si nrog FFS Medicare, MHPs tsis tas yuav them nqi rau Medicare Fee-For-Service rau kev them rov qab rau cov kev pabcuam uas DHCS tau txiav txim siab tias Medicare tsis them vim tias qhov kev pabcuam, hom tus neeg muab kev pabcuam, lossis kev sib xyaw ua ke ntawm cov kev pabcuam, hom tus neeg muab kev pabcuam, thiab qhov chaw pabcuam tsis tau them rov qab los ntawm Medicare.
Txhua Lub Chaw Npaj Kev Noj Qab Haus Huv Lub Siab yuav tsum nkag mus rau hauv lub vev xaib MedCCC txhua lub sijhawm kom paub tseeb tias lub tuam txhab pov hwm nyob hauv daim ntawv teev npe.
Txoj Kev Npaj Kho Mob Hlwb tau txais tsab ntawv pov thawj lees paub tias txoj kev npaj tsis muab kev pab them nqi ntxiv rau cov kev pabcuam kho mob hlwb tshwj xeeb tshaj li qhov uas FFS Medicare muab. Tsab ntawv pov thawj yuav tsum muaj cov ntaub ntawv hauv qab no:
Lub npe ntawm daim phiaj xwm Medicare Advantage;
Tus lej cog lus hauv tebchaws; thiab
Xyoo (cov) kev pabcuam uas nws siv tau, uas yuav tsum tsis txhob suav nrog ib xyoos twg ntawm kev pabcuam tom qab xyoo tom qab hnub ntawm tsab ntawv.
Lub MHP xa tsab ntawv pov thawj mus rau MedCCC ntawm Mental Health Services Division, County Customer Service Section ntawm: MedCCC@DHCS.CA.GOV siv kab ntawv sau: "FFS-Equivalent Coverage Certification."
MedCCC ua kom ntseeg tau tias lub kaw lus SDMC yuav kho qhov kev npaj no ua ib qho kev npaj sib npaug rau FFS thaum txiav txim siab cov kev pabcuam rau cov hnub pabcuam uas tau teev tseg hauv tsab ntawv pov thawj.
Cov MHP uas muaj cov kev thov uas tau raug tsis lees paub ua ntej vim tias cov kev pabcuam tsis tau raug them nqi rau tus neeg tau txais txiaj ntsig txoj kev npaj Medicare Advantage ua ntej yuav xa cov kev thov hloov pauv rau txhua qhov kev thov uas raug tsis lees paub uas suav nrog cov kev pabcuam uas tsis tas yuav them nqi rau txoj kev npaj Medicare Advantage ua ntej them nqi rau Medi-Cal.
Certification Status
| Lub Npe Health Plan | Tsoom Fwv Teb Chaws Daim Ntawv Cog Lus # | Hnub tau txais | Hnub Ua Haujlwm |
Hnub Tim Tau Txais Daim Ntawv Pov Thawj (Kho Dua Lub Plaub Hlis, 2026) |
|---|---|---|---|---|
| Aetna Better Health of California | H4982 | 4/3/2023 | 4/25/2023 | 01/01/2023 – 12/31/2023 |
| Aetna Health ntawm California | H0523 & H5521 | 07/29/14 | 09/03/14 | 01/01/12 – 12/31/15 |
| Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Aids, dba Cov Neeg Koom Tes Saib Xyuas Kev Noj Qab Haus Huv Zoo (PHP) | H5852 | 01/13/17 | 01/25/17 | 01/01/14 – 12/31/17 |
| Alameda Alliance for Health | H7292 | 02/25/14 | 04/24/14 | 01/01/10 – 12/31/15 |
| Alameda Alliance for Health | H2035 | 12/02/25 | 03/24/26 | 01/01/26 – 12/31/26 |
| Alignment Health Plan yav dhau los Citizens Choice Health Plan HMO | H3815 | 04/01/26 | 04/01/26 | 01/01/13 – 12/31/17 01/01/25 – 12/31/26 |
| Anthem Blue Cross | H4471 | 11/25/2025 | 12/24/2025 | 01/01/25 – 12/31/26 |
| Blue Shield | H0504 | 04/06/17 | 04/10/17 | 01/01/14 – 12/31/17 |
| Blue Shield ntawm California | H2819 | 03/30/26 | 04/01/26 | 01/01/25 – 12/31/26 |
| Blue Shield ntawm California | H5609 | 04/06/17 | 04/10/17 | 01/01/16 – 12/31/17 |
| CalOptima yog | H5433 | 12/03/2025 | 12/24/2025 | 01/01/14 – 12/31/26 |
| Care First Total Dual Plan aka BSC Promise Health Plan | H5928 | 03/16/23 | 03/30/23 | 01/01/08 – 12/31/23 |
| CareMore Health Plan | H0544 | 05/09/16 | 06/15/16 | 01/01/16 – 12/31/16 |
| CenCal Health | H7620 | 4/15/2026 | 4/16/2026 | 01/01/2026 – 12/31/2026 |
| Central California Alliance for Health | H5692 | 11/12/2025 | 12/23/2025 | 01/01/26-12/31/26 |
| Central Health Medicare Plan of California | H5649 | 07/13/16 | 08/24/16 | 01/01/12 – 12/31/17 |
| Pawg Saib Xyuas Kev Noj Qab Haus Huv | H4733 | 11/13/2025 | 12/24/2025 | 01/01/25 -12/31/26 |
| Pawg Saib Xyuas Kev Noj Qab Haus Huv | H5172 | 02/10/14 hnub | 04/24/14 | 01/01/14 – 12/31/15 |
| Pawg Saib Xyuas Kev Noj Qab Haus Huv | H7086 | 07/27/20 | 09.04.20 | 01/01/14 – 12/31/20 |
| Contra Costa Care Plus Dual Eligible Special Needs Plan | H5119 | 04/08/26 | 04/09/26 | 01/01/26 – 12/31/26 |
| Suav Community Health Plan | H0571 | 11/13/2025 | 12/23/2025 | 01/01/22 -12/31/26 |
| Ib qho yooj yim Choice Health Plan | H5087 | 10/07/14 hnub | 01/13/15 | 01/01/14 – 12/31/15 |
| Health Net ntawm California, Inc. | H0562 | 03/28/23 | 05/01/23 | 01/01/14 – 12/31/23 |
| Health Plan ntawm San Mateo | H5428 | 12/06/21 | 12/29/21 | 01/01/10 – 12/31/22 |
| CareAdvantage Mediconnect | H7885 | 12/14/22 | 02/02/23 | 01/01/10 – 12/31/22 |
| CareAdvantage Dual Tsim Nyog | H6019 | 11/26/25 | 12/23/25 | 01/01/23 – 12/31/26 |
| IEHP DualChoice | H8894 | 11/12/2025 | 12/24/2025 | 01/01/25 – 12/31/26 |
| Inland Empire Health Plan (IEHP) | H5640 | 02/08/16 | 06/15/16 | 01/01/11 – 12/31/16 |
| Inter Valley Health Plan | H0545 | 03/14/16 | 06/15/16 | 01/01/14 – 12/31/16 |
| LA Care Health Plan | H2643 | 02/29/16 | 06/15/16 | 09/26/13 – 12/31/14 |
| Molina Healthcare ntawm California | H5810 | 03/13/23 | 03/17/23 | 01/01/11 – 12/31/23 |
| Partnership Health Plan of California | H5782 | 01/28/14 | 05/13/14 | 03/01/10 – 12/31/15 |
| Santa Clara Family Health Plan | H4045 | 11/13/2025 | 12/24/2025 | 01/01/25 – 12/31/26 |
| SCAN Health Plan | H5425 | 07/13/16 | 08/24/16 | 01/01/11 – 12/31/17 |
| United Healthcare of California/Secure Horizons | H0543 | 05/23/14 hnub | 06/16/14 | 01/01/10 – 12/31/15 |