Over
650
Specialists
Specialists
Over
350
Primary Care
Facilities
Primary Care
Facilities
Over
17
Area
Hospitals
Area
Hospitals
Statewide
Network of
Pharmacies
Through
Medi-Cal RX
Over 345 Primary Care Facilities
Over 11 Area Hospitals
Statewide Network of Pharmacies Through Medi-Cal RX
Our Medi-Cal Program in San Joaquin, Stanislaus, El Dorado, and Alpine Counties provides a full range of medical benefits and services. A primary advantage for individuals enrolling in Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) is access to hundreds of Primary Care Physicians (PCPs), most area hospitals and thousands of specialists. Click on a benefit to learn more.
Are You Looking for Information About Other Benefits and Services?
The Evidence of Coverage (EOC) booklet also has a list of the kinds of services Health Plan covers. There are no copayments for these covered services. Your financial responsibility is $0 for these covered services. Practitioners, providers or other parties cannot and should not bill you for these covered services. You may get a medical bill if you go to a doctor that does not work with Health Plan or is located outside of Health Plan’s Service Area. If this happens, then you may be billed by the doctor and you may have to pay for services that are not covered by Health Plan. See Section 4 of the EOC, How Do I Get Care When I Need It.
Because you also get Medi-Cal, you may be able to get other services Health Plan does not cover but you may have to use the Medi-Cal fee-for-service program to get those services. See Section 6 of the EOC, Your Medi-Cal Benefits Not Covered by Health Plan.
Remember: Except for emergency or urgent care services, Health Plan covers only services and supplies that you need and that are provided, prescribed or authorized by your PCP, and, if necessary, approved by Health Plan. If you disagree with what is covered, see Section 2 of the EOC, Members Rights and Responsibilities.
If you have a question about what is covered, call Customer Service toll-free 1-888-936-PLAN (7526) TTY 711, Monday – Friday, 8:00 a.m. to 5:00 p.m.
Posted on June 16th, 2015 and last modified on October 3rd, 2024.
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