Frequently Asked Questions

How do I apply for Partnership HealthPlan of California health benefits?
To enroll in the Medi-Cal program managed by Partnership, call or visit your county department that handles Medi-Cal enrollments. This may be called the Department of Social Services, the Department of Health and Social Services, or something similar. You are automatically enrolled in Partnership based on the type of Medi-Cal you qualified for and the county you live in. You can also enroll in Medi-Cal through Covered California at http://www.coveredca.com/ or toll free at
(800) 300-1506. TTY users can call (888) 889-4500.

What is the Partnership Member Portal?
The Partnership Member Portal provides quick access to do the following:

• Change your primary care doctor
• Order and print an ID card
• View your prior authorizations
• View your claim history

Click here to sign-up today: https://member.partnershiphp.org

Why did I get a Partnership ID card in the mail?
You received a Partnership ID card because you qualified for Medi-Cal benefits in your county. Enrollment in Partnership is required for you to get Medi-Cal benefits. Your enrollment in Partnership is based on the type of Medi-Cal you receive and the county you live in.

How can I cancel my enrollment in Partnership? I did not sign up for this.
Enrollment in Partnership is required for you to get Medi-Cal benefits. Members cannot choose to leave Partnership to go to State Medi-Cal. You can only cancel your enrollment in Partnership for one of the following reasons:

• You have moved to a county not covered by Partnership
• You no longer qualify for Medi-Cal
• Your Medi-Cal coverage changes to a category not covered by Partnership
  
  

Are vision services covered?
Yes, Partnership's vision services are covered through Vision Services Plan (VSP). You can get one routine eye exam and glasses every 24 months. Check the provider directory for a list of vision providers or contact VSP at (800) 877-7195,
Monday – Friday, 5 a.m. to 8 p.m., Saturday, 7 a.m. to 8 p.m., Sunday 7 a.m. to 7 p.m.

Are dental services covered?
Dental services are covered through the Medi-Cal Dental Program. If you have questions or want to learn more about dental services, call the Medi-Cal Dental Program at (800) 322-6384. TTY users call (800) 735-2922 or 711. You may also visit the Medi-Cal Dental Program website or the Smile California website.

How to get the medical care you need?

• Make an appointment to see your doctor for a check-up within 90 days after your Medi-Cal starts.
• When you go to the doctor, bring your Medi-Cal card and your Partnership ID card with you.
• Always try to keep your appointments and try to get there 15 minutes early.
• If you must cancel your appointment, call at least 24 hours in advance.
• Make a list of questions to ask your doctor. Bring your list with you.
• If something is not clear, tell your doctor. If you get home and forgot what your doctor told you, call your doctor's office and ask for the answer or directions again.
• Tell your doctor about all the medicine you are taking, even over-the-counter medicines. You can make a list of your medicines to give to your doctor. When your doctor gives you a new prescription, ask if there are any side effects or foods you should not eat. Ask when the medicine should be taken.
• For emergency care, call 911 or go to the nearest emergency room (ER). For emergency care, you do not need
• pre-approval (prior authorization) from Partnership.
• Do not go to the ER for routine care or care that is not needed right away. If you are not sure if your medical condition is an emergency, call your primary care doctor. You may also call the 24/7 Advice Nurse at (866) 778-8873.
  
  

I need to see a specialist, how do I do that?
If you need specialty care, your primary care doctor will make a referral for you. This referral from your doctor is your approval to see a specialist. For more information, click here.

Where can I go for urgent care?
First call your primary care doctor. You may speak to someone who answers calls for your doctor when the office is closed. Ask to speak to your doctor or the doctor on call. Another doctor may take your call when your doctor is not available.

Tell the doctor about your condition and follow their instructions.

You can also call our advice nurse at (866) 778-8873, 24 hours a day, 7 days a week.

You can find urgent care centers in your Provider Directory, click here.

What are my benefits when I'm traveling outside of my resident county and/or out of the state of California (within the United States)?
Your benefits are limited to emergency services and urgent care while outside of your county. If you have a life-threatening emergency while you are away from your home, you should go to the closest emergency room.

What does pre-approval (prior authorization, prior approval) or TAR mean?
Your doctor must get approval from Partnership before you get certain services. Partnership will only approve the services you need. This is also referred to as a Treatment Authorization Request (TAR).

For more information click here.

What does Direct Member mean?
Not all members will be assigned to a primary care doctor. Members not assigned to a primary care doctor are called Direct Members. The following are examples of Direct Members: children in foster care, members with end stage renal disease, members residing in a long term facility, and members with other health coverage. Even though Direct Members can see any Medi-Cal provider, pre-approval is still needed for certain services. If you think you may qualify for Direct Member assignment, please contact Partnership's Member Services Department.

What if I have a share-of-cost (SOC)?
Share-of-cost (SOC) is a set amount you will need to pay providers each month when receiving Medi-Cal covered services. The SOC amount is determined by your Medi-Cal office. After you meet your SOC, you are eligible to receive Medi-Cal covered services for the month with no out of pocket expenses.

If you have questions about your share-of-cost amount, please contact your local Medi-Cal office.

Will I be responsible for any co-pays, premiums, or out of pocket expenses?
If you have a share-of-cost (see question above), you will need to pay that amount each month to your provider. There is no other co-payment, premiums, or out of pocket expenses if you receive Medi-Cal covered benefits through a Medi-Cal doctor.

Your county Medi-Cal office can help with the questions below:

• How long does my Medi-Cal coverage last?
• When do I need to renew my Medi-Cal coverage?
• Who should I contact if I cannot use my Medi-Cal benefits anymore?
• How can I order a new Medi-Cal ID card?