OneCare Frequently Asked Questions
What is Medicare Advantage?
Medicare Advantage combines Medicare Part A (hospital), Medicare Part B (medical) and Part D (prescription drugs) into one plan. This is also known as Part C.What is a D-SNP plan?
A dual-eligible special needs plan (D-SNP) is a type of Medicare Advantage plan for people who get both Medicare and Medi-Cal. Medicare Advantage D-SNP plans, such as CalOptima Health OneCare Complete, are made to meet your unique needs, so that you can get your Medi-Cal and Medicare benefits and services in one place.Do I meet the requirements for OneCare?
You could qualify to be a OneCare member if you:
- Live in Orange County
- Have Medicare Parts A and B
- Have full Medi-Cal with no Share of Cost
- Are age 21 or older
How will OneCare help me?
With OneCare, your Medicare, Medi-Cal and Part D benefits are together in one health plan, making it easier for you to understand and use your benefits. You’ll also have access to certain home and community services to help you live safely at home.Can I still see my regular doctor?
Yes, you can see them if they are part of our growing network of more than 8,000 doctors. If your doctor is not in our network, you can keep seeing them for a period of time if they agree to work with OneCare.How much does OneCare cost?
You can enroll in OneCare at no cost. You don’t pay plan premiums, deductibles, copays or coinsurance for medical services. However, you might have Standard Part D copays for brand-name medicines with OneCare Complete. Call us at 1-877-412-2734 (TTY 711) to learn more.Does OneCare cover transportation?
Yes, you’ll have unlimited trips at no cost to and from your doctor visits, pharmacy and the gym.Will I lose my Medi-Cal (Medicaid) if I get Medicare?
No. OneCare brings your Medi-Cal and Medicare benefits together, so it’s easier for you to get the care you need. With OneCare, you’ll keep getting all the benefits you’re used to, including medical, drug coverage and extra services, such as vision and hearing.Who is eligible for both Medicare and Medi-Cal (Medicaid)?
You may enroll in Medicare if you are age 65 or older, or if you are under age 65 and have a qualifying disability or certain medical conditions. You may be eligible for Medi-Cal (Medicaid) depending on your income and other factors.What is Medicare Part D?
Medicare Part D coverage is a federal program that helps pay for prescription drugs. OneCare includes Medicare Part D prescription drug coverage.
If you qualify for Medicare Part A (hospital) or are enrolled in Medicare Part B (medical), you can sign up for Medicare Part D. If you qualify for both Medicare and Medi-Cal, you may enroll in OneCare, which includes Medicare Part D.How Much does Medicare Part D cost?
Medicare Part D costs can vary. With OneCare there is no premium, and you could have no or very low copays for your medicines.What does Medicare Part D cover?
Medicare Part D can cover generic and brand-name medicines, such as those people take for chronic conditions (diabetes, high blood pressure). With OneCare, you’ll have access to a formulary that has all the medicines you need.