CenCal Health

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Para Miembros

Seleccione Su Plan Health Initiative Healthy Families AIM In-Home Support Healthy Kids SB Healthy Kids SLO HIPAA Privacy Practices & Confidentiality Reporte Fraude y Abuso

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Care Management

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For Providers: Asthma Action Plans For Providers: Staying Healthy Forms For Providers: Lead Screening Handout For Providers: Diabetes Action Plan For Providers: Make a Change Tool For Providers: Smoking Cessation Services

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SITEMAP

For Members > Enrollment Information

For Members - Enrollment Information

1. Health Initiative (Medi-Cal)

2. Healthy Families
State of California Website address:
http://www.healthyfamilies.ca.gov

3. Access for Infants and Mothers (AIM)

4. Healthy Kids

CenCal Health Service Area

The CenCal Health service areas are the Counties of Santa Barbara and San Luis Obispo.

Santa Barbara County: The Health Plan service area in the County of Santa Barbara includes Ballard, Buellton, Carpinteria, Casmalia, Gaviota, Goleta, Guadalupe, Isla Vista, Lompoc, Los Alamos, Los Olivos, Montecito, New Cuyama, Orcutt, Santa Barbara, Santa Maria, Santa Ynez, Solvang, and Summerland.

San Luis Obispo County: The Health Plan service area in the County of San Luis Obispo includes Arroyo Grande, Atascadero, Avila Beach, Cambria, Cayucos, Grover Beach, Los Osos, Morro Bay, Nipomo, Oceano, Paso Robles, Pismo Beach, San Luis Obispo, San Miguel, Santa Margarita, Shell Beach and Templeton.

Medi-Cal Eligibility

To receive Medi-Cal you must apply through the Department of Social Services or be receiving Supplemental Security Income (SSI) through the Social Security Administration.

If you're eligible for Medi-Cal through the Department of Social Services, you must report any changes in your family size, income, assets (property), or change of address so that necessary changes can be made to your case. If you have a Share of Cost, your Medi-Cal worker will tell you the amount of your Share of Cost. You'll need to talk to your Medi-Cal worker about any questions or problems you have with your Medi-Cal eligibility or Share of Cost.

If you have Medi-Cal because you are receiving SSI, you will not have a Medi-Cal worker. You will need to report a change of address to the Social Security Office at 1-800- 772-1213. If you move out of our service area, you will need to call the Social Security Administration in the town you're moving to, and tell them about your change of address. If you don't do this, you may have problems receiving health care in your new county. It can take several months for Social Security to make the change, so please report the change as soon as you know your new address. The Health Plan cannot change your Medi-Cal to another county.

Transitional Medi-Cal
Transitional Medi-Cal (TMC) is available to people who lose their cash grant or Medi-Cal eligibility because their income has gone up. TMC is sometimes referred to as "Medi-Cal for working people".

Transitional Medi-Cal is available to primary wage earners or caretaker relatives (as defined by Medi-Cal) and their children who lose their cash grant because their income from employment has increased.

Parents, caretaker relatives, and children who meet the requirements for TMC may continue to get free Medi-Cal coverage for up to 12 months. If you lose your current eligibility for Medi-Cal, you should immediately ask your Medi-Cal eligibility worker whether you qualify for TMC. If you do qualify for TMC, you will continue to be a Health Plan member.

Healthy Families Program

If your child no longer qualifies for Medi-Cal or has Medi-Cal with a Share of Cost, he or she may be eligible for the Healthy Families Program. Healthy Families provides low-cost medical, dental, and vision care for children up to age 19 whose family incomes are below a certain amount. Monthly premiums are from $4 - $14 per child per month, up to a maximum of $42 per family per month. There are $5 and $10 co-payments required for some services. To get more information about Healthy Families and to see if your child qualifies, please call 1-888-747-1222 or call the Member Services Department at 1-877-814-1861.

Access for Infants and Mothers Program

The State of California established the Access for Infants and Mothers (AIM) Program to increase access to health care services for pregnant women who do not qualify for Medi-Cal. CenCal Health is the health plan offering Access for Infants and Mothers (AIM) Program to women enrolled in AIM who live in Santa Barbara County. To find out more about the AIM program, call 1-800-433-2611. To find out more about the AIM program, call CenCal Health's Member Services Department at 1-877-814-1861.

Healthy Kids Program

Healthy Kids is a health care coverage program that is funded with both private and public funds. If funds are available, all of the following must be met in order to be eligible:

Under 19 years of age
A resident of Santa Barbara or San Luis Obispo County
Family has annual or monthly income equal to or less than 300% of the Federal Poverty Level
Not eligible for Medi-Cal or Healthy Families or not covered by employer sponsored health care coverage within the last 3 months

For more information about the Healthy Kids program, please call CenCal Health's Member Services Department at 1-877-814-1861.