OneCare (HMO SNP)

Frequently Asked Questions

Common questions and answers about OneCare

What is OneCare (HMO SNP)?

OneCare (HMO SNP) is a Medicare Advantage Plan that combines your Medicare, prescription drug, and Medi-Cal benefits into one plan. OneCare is a program offered through CalOptima.

Can you enroll in OneCare?

You can enroll in OneCare if you:

  • Have full Medi-Cal with no Share of Cost
  • Have Medicare Parts A, B and D
  • Live in Orange County, CA
  • Are not eligible for OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan)

What benefits are covered under OneCare?

OneCare offers the benefits of Medicare, Medi-Cal and more in one program.

Are prescription drugs covered?

Yes, based on an approved formulary which may change from year to year. Some drugs may require prior authorization, step therapy or quantity limits

Are vision services covered?

Yes. Vision includes eye exams and eyewear, but there are some limits. Please contact OneCare for details.

What makes OneCare easy to use?

With many health plans, it’s hard to understand and use the benefits. It is even harder when you have Medicare, Medi-Cal and Part D (prescription drugs). With OneCare your Medicare, Medi-Cal and Part D benefits are together in one health plan.

How much does OneCare cost?

There is no cost to enroll in OneCare. You do not pay plan premiums, or deductibles. You also do not pay a co-pay or co-insurance for medical services. You may have co-payments for some prescription drugs. Please contact OneCare for more details.

Can you choose your doctor and hospital?

Yes. You can choose from a large network of doctors in Orange County. OneCare also has hospitals in your area.

Does OneCare cover transportation?

Yes. You have unlimited transportation benefit for your doctor visits at no cost to you. You can also get non-medical transportation to plan-approved locations, including the gym.

How can you enroll in OneCare?

For more information about OneCare or to enroll, please call us at the numbers below.

Contact Us
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New OneCare Members

To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_WEB020_M Accepted 06/17/19

OneCare (HMO SNP) is a Medicare Advantage organization with a Medicare contract. Enrollment in OneCare depends on contract renewal. Eligible beneficiaries can enroll at any time. Eligible beneficiaries must have Part A and Part B to enroll in the plan. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other Pharmacies/Physicians/Providers are available in our network. Medicare beneficiaries may also enroll in OneCare (HMO SNP) through the CMS Medicare Online Enrollment Center located at Medicare has neither reviewed nor endorsed this information. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. OneCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. This information is available for free in other languages. Please call our customer service number at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users should call 1-800-735-2929.

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