Central California Alliance for Health | Living Healthy | September 2019

HEALTHY 4 What you need to know about other health coverage If you have more than one health insurance plan, it is important to understand the rules that say which plan pays first and which pays second. The health plan that pays first is called primary insurance . The health plan that gets billed next is called secondary insurance . If you have other insurance plus Medi-Cal, your other insurance is the primary insurance. If the primary insurance has special rules, you must follow them. You must see special doctors and go to certain hospitals. If you don’t follow the rules of your primary insurance and use its provider network, it may not pay for your care and the Alliance will not pay for it either. Who do I contact if my insurance changes? If you have Medi-Cal, call your county Medi-Cal office. It is important that you give them this information so they can update your case. You should also call the Alliance’s Member Services Department. We will have to verify that your other insurance has changed before we update your information. ●  ● Merced County: (209) 385-3000 ●  ● Monterey County: (877) 410-8823 ●  ● Santa Cruz County: (888) 421-8080 Why is it important that I update my primary insurance information? ●  ● To make sure there are no problems with being seen at your doctor’s office or getting prescriptions at the pharmacy ●  ● So you won’t get a bill from your doctor’s office If you have Medicare Parts A, B and D with Medi-Cal: Your Medicare is always your primary insurance. ●  ● Medicare Part A pays for hospital stays. You don’t need authorization from the Alliance for hospital care. ●  ● Medicare Part B pays for doctor visits. You can go to any provider that takes Medicare, unless you are in a Medicare Advantage Plan. ●  ● Medicare Part D pays for prescription medicines that are covered by your Medicare drug plan. You will have to pay a small co- pay for each prescription. ●  ● Medicare has an annual deductible and co-insurance. Your Medi-Cal health plan is always secondary. ●  ● You will not pick an Alliance primary care provider. You can go to any doctor that takes Medicare. ●  ● If your doctor accepts Medi-Cal as your secondary insurance, he or she will bill the Alliance for the deductible and co-insurance. ●  ● You should not receive a bill. You will only pay prescription co-pays. ●  ● The Alliance will cover a small