2026 Disclaimers
Loading component...
- Approval Code :
- H5433_26WEB001_M_2026
- Accepted :
- 9/9/25
To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.
CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan, is a Medicare Advantage organization with Medicare and Medi-Cal contracts. Enrollment in CalOptima Health OneCare depends on contract renewal. Eligible beneficiaries can enroll at any time. Eligible beneficiaries must have Parts A, B and D to enroll in the plan. Contact the plan for more information. Medicare beneficiaries may also enroll in OneCare (HMO D-SNP) through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
This information is not a complete description of benefits. 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. Medicare has neither reviewed nor endorsed this information. The list of covered drugs (formulary), provider and pharmacy network may change at any time. You will receive notice when necessary. Other Pharmacies/Physicians/Providers are available in our network. Contact OneCare Customer Service if you need help finding a provider.
OneCare complies with all applicable state and federal civil rights laws and does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. This information is available for free in other languages. Call OneCare Customer Service toll-free at 1-877-412-2734 (TTY 711), 24 hours a day, 7 days a week. Visit us at www.caloptima.org/health-insurance-plans/OneCare.
2025 Special Supplemental Benefits for the Chronically Ill (SSBCI):
The 2025 food and produce benefit is available to all CalOptima Health OneCare Complete members. The CalOptima Health OneCare Flex Plus food and produce benefit is part of a special supplemental program for the chronically ill. Not all members qualify. To use the food and produce benefit, OneCare Flex Plus members must have one or more comorbid and medically complex chronic conditions that are life-threatening or significantly limit the overall health or function of the enrollee. Eligible conditions include, but are not limited to, cardiovascular disorder, diabetes mellitus, chronic heart failure, chronic lung disease or end-stage renal disease. Even if the member has a chronic condition, the member will not necessarily receive the food and produce benefit. Receiving the food and produce benefit depends on the member having a high risk of hospitalization or other adverse health outcomes and a need for intense care coordination. Transportation to the grocery store is not available to OneCare Flex Plus members.
2026 Special Supplemental Benefits for the Chronically Ill (SSBCI):
This benefit is a Special Supplemental Benefit for the Chronically Ill (SSBCI). To qualify, you must have a qualifying chronic condition such as heart disease, diabetes, cancer, lung disease or dementia. Not all members with a chronic condition will qualify. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please see Chapter 4 in the CalOptima Health OneCare Complete Member Handbook.