Medicare Plus Plan Overview
How Members Benefit
With L.A. Care Medicare Plus, members can choose among a large network of high quality primary care providers and specialists. You can see a doctor who speaks your language and understands your background and needs.
L.A. Care Medicare Plus offers complete care that coordinates your Medicare and Medi-Cal benefits, helps with access to resources like housing and food, and offers benefits and services like care managers and 24/7 customer service at no cost.
Members have trusted L.A. Care to provide access to high quality health care for more than 25 years. L.A. Care is here to stay. L.A. Care employees live and work in in the same communities where our members live, giving us unique insight into the needs of our members
L.A. Care Medicare Plus is here to deliver coordinated and seamless healthcare that supports members’ health and independence. L.A. Care Medicare Plus coordinates all Medicare and Medi-Cal benefits as one health plan that includes, but not limited to, the following:
- Medical Care
- Prescription Medications
- Mental Health and Behavioral Health Care
- Long Term Services and Supports (LTSS)
- Connection to Social Services (for assistance with housing, food, bills, and much more)
- Other-the-Counter and nutritional allowance
- Gym membership
- Dental (Medi-Cal)
- Hearing (Medi-Cal)
- Transportation (Medi-Cal)
- Worldwide Emergency Coverage
- Personal Emergency Response systems (PERS)
For more information, please visit us at: https://medicare.lacare.org/
Continuity of Care
If you now see providers who are not in the L.A. Care network, in certain cases you may be able to keep seeing them for up to 12 months. If your providers do not join the L.A. Care network by the end of 12 months, you will need to switch to providers in the L.A. Care network. You can continue to see your providers when:
- L.A. Care determines you have an existing relationship with your out-of-network provider. An existing relationship means you saw the out-of-network PCP or specialist at least once during the 12 months prior to the date of your initial enrollment with L.A. Care for a non-emergency visit.
- Your out-of-network provider is willing to accept the higher of L.A. Care’s contract rates or Medi-Cal FFS rates.
- Your out-of-network provider meets L.A. Care’s applicable professional standards and has no disqualifying quality-of-care issues.
- Your out-of-network provider is a California State Plan approved provider; and
- The provider supplies L.A. Care with relevant treatment information.
Members, their authorized representatives, or providers may make a direct continuity of care request to L.A. Care in writing or by telephone.
At any time, a member may change providers to a provider who is a member of an L.A. Care network.