HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Acupuncture Provider (ASH) Acupuncture Services Only. Please refer to the Member Handbook for covered benefits and services. TeleHealth Telehealth offers access to doctors by phone or video 24 hours a day, seven days a week. If you would like to access TELADOC® for these services please call 1-800-

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High

Risk/Complex

2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

AUTHORIZATION REQUEST FORM Title: Authorization Request Form Author: L.A. Care Health Plan Subject: Authorization Request Form Keywords: Authorization Request

Form Created Date

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Acupuncture Provider (ASH) Acupuncture Services Only. Please refer to the Member Handbook for covered benefits and services. TeleHealth Telehealth offers access to doctors by phone or video 24 hours a day, seven days a week. If you would like to access TELADOC® for these services please call 1-800-

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High

Risk/Complex

2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

AUTHORIZATION REQUEST FORM Title: Authorization Request Form Author: L.A. Care Health Plan Subject: Authorization Request Form Keywords: Authorization Request

Form Created Date

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

L.A. CARE PROVIDER PORTAL Acupuncture Provider (ASH) Acupuncture Services Only. Please refer to the Member Handbook for covered benefits and services. TeleHealth Telehealth offers access to doctors by phone or video 24 hours a day, seven days a week. If you would like to access TELADOC® for these services please call 1-800-

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

PAYMENTS | L.A. CARE HEALTH PLAN Create a member log-in and make your first payment through L.A. Care Connect. Mail a check or money order to the L.A. Care Covered payment address or L.A. Care Covered Direct payment address: L.A. Care Health Plan. L.A. Care Covered ™. P.O. Box 741507. Los Angeles, CA 90074-1507. L.A. Care Health Plan. L.A. Care Covered ™ Direct.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

MENTAL HEALTH SERVICES For help finding more information on mental health services provided by L.A. Care, call 1-888-839-9909 (TTY 711). If your mental health screening results determine you may have a higher level of impairment and need specialty mental health services (SMHS), your PCP or your mental health provider will refer you to the county mental health plan

to

JUNE 2021 FORMULARY UPDATES L.A. Care makes changes to the list of drugs covered by L.A. Care (known as the formulary). This helps meet the needs of our members and

providers.

L.A. CARE HEALTH PLAN L.A. Care . Covered ™ & L.A. Care . Covered ™ Direct (Updated INTRODUCTION Foreword L.A. Care Covered ™ & L.A. Care Covered ™. Direct formulary is a preferred list of covered drugs, approved by the L.A. Care Health Plan Pharmacy Quality Oversight Committee. Q&A: LA CARE HEALTH PLAN CEO JOHN BAACKES ON THE CO Baackes discusses L.A. Care as a public option, health disparities, and legislative proposals, including expanding Medi-Cal. HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Acupuncture Provider (ASH) Acupuncture Services Only. Please refer to the Member Handbook for covered benefits and services. TeleHealth Telehealth offers access to doctors by phone or video 24 hours a day, seven days a week. If you would like to access TELADOC® for these services please call 1-800-

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

L.A. CARE COVERED 2021 PLANS AT A GLANCE Platinum 90 HMO Gold 80 HMO Silver 70 HMO Silver 94 HMO Silver 87 HMO Silver 73 HMO Bronze 60 HMO Minimum GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High

Risk/Complex

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Acupuncture Provider (ASH) Acupuncture Services Only. Please refer to the Member Handbook for covered benefits and services. TeleHealth Telehealth offers access to doctors by phone or video 24 hours a day, seven days a week. If you would like to access TELADOC® for these services please call 1-800-

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

L.A. CARE COVERED 2021 PLANS AT A GLANCE Platinum 90 HMO Gold 80 HMO Silver 70 HMO Silver 94 HMO Silver 87 HMO Silver 73 HMO Bronze 60 HMO Minimum GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High

Risk/Complex

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

PAYMENTS | L.A. CARE HEALTH PLAN Create a member log-in and make your first payment through L.A. Care Connect. Mail a check or money order to the L.A. Care Covered payment address or L.A. Care Covered Direct payment address: L.A. Care Health Plan. L.A. Care Covered ™. P.O. Box 741507. Los Angeles, CA 90074-1507. L.A. Care Health Plan. L.A. Care Covered ™ Direct.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

BEHAVIORAL HEALTH SERVICES L.A. Care provides mental health services and substance use disorder services through PCP’s, Behavioral Health Specialists from Beacon Health Services, Los Angeles County Department of Mental Health, and Los Angeles County Department of Public Health. Mental health services may include treatment for anxiety, depression, or behavior health problems. Your doctor can provide you with some MENTAL HEALTH SERVICES For help finding more information on mental health services provided by L.A. Care, call 1-888-839-9909 (TTY 711). If your mental health screening results determine you may have a higher level of impairment and need specialty mental health services (SMHS), your PCP or your mental health provider will refer you to the county mental health plan

to

JUNE 2021 FORMULARY UPDATES L.A. Care makes changes to the list of drugs covered by L.A. Care (known as the formulary). This helps meet the needs of our members and

providers.

L.A. CARE HEALTH PLAN L.A. Care . Covered ™ & L.A. Care . Covered ™ Direct (Updated INTRODUCTION Foreword L.A. Care Covered ™ & L.A. Care Covered ™. Direct formulary is a preferred list of covered drugs, approved by the L.A. Care Health Plan Pharmacy Quality Oversight Committee. Q&A: LA CARE HEALTH PLAN CEO JOHN BAACKES ON THE CO Baackes discusses L.A. Care as a public option, health disparities, and legislative proposals, including expanding Medi-Cal. HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Search for additional Providers or Call Member Services toll-free at

1-855-270-2327

L.A. CARE SIGN-IN

User Name: Password: This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. 2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

BRONZE 60 HMO

lacare.org: or call 1-855-270-2327 (TTY 711) for a list of network providers. This : plan uses a provider network. You will pay less if you use a participating provider in the CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High Risk/Complex Care Management (CM) support to members to REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. CARE PROVIDER PORTAL Search for additional Providers or Call Member Services toll-free at

1-855-270-2327

L.A. CARE SIGN-IN

User Name: Password: This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. GUIDE TO HEDIS® MEASURES MY 2021 L.A. Care Health Plan (L.A. Care) is an National Committee for Quality Assurance (NCQA) accredited health plan. HEDIS® is the gold standard for measuring quality health care performance, and is part of 2021 L.A. CARE COVERED SILVER 70 HMO SUMMARY OF BENEFITS plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. 2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

BRONZE 60 HMO

lacare.org: or call 1-855-270-2327 (TTY 711) for a list of network providers. This : plan uses a provider network. You will pay less if you use a participating provider in the CARE MANAGEMENT REFERRAL FORM CM Referral Form FINAL_4.13.20 LA3001 09/20 Care Management Referral Form Care Management Guide for Referral L.A. Care provides High Risk/Complex Care Management (CM) support to members to REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

FAMILY RESOURCE CENTERS L.A. Care and Blue Shield Promise Community Resource Centers. L.A. Care and Blue Shield Promise are committing a combined $146 million to develop and expand Community Resource Centers across Los

L.A. CARE CONNECT

Close this notification For a better mobile experience, download our

app:

MENTAL HEALTH SERVICES Outpatient Mental Health Services The L.A. Care covers a member for an initial mental health assessment without requiring pre-approval (prior authorization). You may get a mental health assessment at any time from a licensed mental health provider in the L.A. Care

MAKING A PAYMENT

Welcome to the L.A. Care Family Thank you for selecting L.A. Care Covered™ as your health insurance plan. Here is some important information that will answer your PAYMENTS | L.A. CARE HEALTH PLAN The premium payment is due on the last day of each month. If your payment is not received by the 1st of the month for coverage in the same month, your payment will be considered past due and you will be

sent a

JUNE 2021 FORMULARY UPDATES L.A. Care makes changes to the list of drugs covered by L.A. Care (known as the formulary). This helps meet the needs of our members and

providers.

VISION SERVICES

Medi-Cal Eye exams are covered by L.A. Care for members of all ages. Members who are under 21 years of age, pregnant or living in a nursing home are covered for one pair of eyeglasses every two (2) years unless the prescription changes. This includes lenses and BEHAVIORAL HEALTH SERVICES L.A. Care provides mental health services and substance use disorder services through PCP’s, Behavioral Health Specialists from Beacon Health Services, Los Angeles County Department of Mental Health, and Los Angeles County Department of Public Health. Mental health services may include treatment for anxiety, depression, or behavior health problems. Your doctor can provide you with some Q&A: LA CARE HEALTH PLAN CEO JOHN BAACKES ON THE CO Baackes discusses L.A. Care as a public option, health disparities, and legislative proposals, including expanding Medi-Cal. HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A. 2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS 1 every 6 months. See your plan document for additional information about services . Excluded Services & Other Covered Services: Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.) MEMBER REIMBURSEMENT REQUEST FORM Return completed and signed form to Attn: MPSS Accounts Receivables L.A. Care Health Plan 1055 W 7. th. Street, 10. th. Floor Los Angeles, CA 90017 Fax: (213) 438-6105 Email: MPSS-AR@LACARE.org AUTHORIZATION REQUEST FORM Title: Authorization Request Form Author: L.A. Care Health Plan Subject: Authorization Request Form Keywords: Authorization Request

Form Created Date

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A. 2021 L.A. CARE COVERED GOLD 80 HMO SUMMARY OF BENEFITS AND providers, please see lacare.org or call 1-855-270-2327 This plan uses a provider network. You will pay less if you use a participating

provider in the

2021 L.A. CARE COVERED SILVER 87 HMO SUMMARY OF BENEFITS 12/31/2021 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a

health

SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS 1 every 6 months. See your plan document for additional information about services . Excluded Services & Other Covered Services: Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.) MEMBER REIMBURSEMENT REQUEST FORM Return completed and signed form to Attn: MPSS Accounts Receivables L.A. Care Health Plan 1055 W 7. th. Street, 10. th. Floor Los Angeles, CA 90017 Fax: (213) 438-6105 Email: MPSS-AR@LACARE.org AUTHORIZATION REQUEST FORM Title: Authorization Request Form Author: L.A. Care Health Plan Subject: Authorization Request Form Keywords: Authorization Request

Form Created Date

REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN REFERRAL FORM FOR TRANSPORTATION SERVICES AND PHYSICIAN CERTIFICATION STATEMENT (PCS) The Department of Health Care Services (DHCS) requires that a PCS form is used to process and determine the appropriate level

of

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

COVID-19 VACCINES

Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HEALTHY LIVING & PREVENTION L.A. Care’s Health in Motion™ program helps you reach your health goals with our experienced staff of Certified Health Coaches and Registered Dietitians. We help L.A. Care members: Online through L.A. Care Connect - your personal member account. Over-the-phone with a Certified Health Coach at 1-855-856-6943. In your neighborhood at one

of

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A.

Care

DENTAL SERVICES

Medi-Cal If you are a Medi-Cal member, there are some services L.A. Care Health Plan will cover. Please review the L.A. Care Medi-Cal Member Handbook to learn more about the dental services you can get. For other dental services, Denti-Cal is your dental services provider. To learn more about Denti-Cal or to find a dentist, call Denti-Cal at 1-800-322-6384 (TTY 1-800-735-2922). L.A. CARE’S MEDICAL DIRECTOR FOR QUALITY, DIVERSITY Healthy equity, the ability for everyone to have a fair and just opportunity to be healthy, has become a critical topic during the pandemic. That’s because COVID-19 put a spotlight on longstanding health disparities, with poor communities of color suffering more cases, hospitalizations and deaths. JUNE 2021 L.A. CARE COVERED FORMULARY Direct formulary is a preferred list of covered drugs, approved by the L.A. Care Health Plan Pharmacy Quality Oversight Committee. Tis formulary applies only to outpatient drugs and self-administered

drugs.

L.A. CARE HEALTH PLAN 1 INTRODUCTION Foreword The L.A. Care Health Plan (L.A. Care) PASC-SEIU formulary is a preferred list of covered drugs, approved by the L.A. Care’s Pharmacy Quality Oversight Committee. HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed. PAYMENTS | L.A. CARE HEALTH PLAN Create a member log-in and make your first payment through L.A. Care Connect. Mail a check or money order to the L.A. Care Covered payment address or L.A. Care Covered Direct payment address: L.A. Care Health Plan. L.A. Care Covered ™. P.O. Box 741507. Los Angeles, CA 90074-1507. L.A. Care Health Plan. L.A. Care Covered ™ Direct.

FIND A PROVIDER

Network of Providers. We’re making health care easier to access. With a network of over 60 hospitals, 3,000 physicians and 1,600 pharmacies — including CVS and Rite Aid stores — there's most likely an L.A. Care provider close by. Search the L.A. Care Provider

Directory to

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

L.A. CARE’S MEDICAL DIRECTOR FOR QUALITY, DIVERSITY Healthy equity, the ability for everyone to have a fair and just opportunity to be healthy, has become a critical topic during the pandemic. That’s because COVID-19 put a spotlight on longstanding health disparities, with poor communities of color suffering more cases, hospitalizations and deaths. COMMUNITY RESOURCE CENTERS Building Active, Healthy, & Informed Communities. Our resource centers are open to members and the general public. Get access to a variety of health care and community resources. We invite you to make an appointment today by calling 1-877-287-6290 so that our staff can help you receive the services you need. We’re back and ready to serve

you!

HEALTHY LIVING & PREVENTION L.A. Care’s Health in Motion™ program helps you reach your health goals with our experienced staff of Certified Health Coaches and Registered Dietitians. We help L.A. Care members: Online through L.A. Care Connect - your personal member account. Over-the-phone with a Certified Health Coach at 1-855-856-6943. In your neighborhood at one

of

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A.

Care

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

FIND A PROVIDER

Network of Providers. We’re making health care easier to access. With a network of over 60 hospitals, 3,000 physicians and 1,600 pharmacies — including CVS and Rite Aid stores — there's most likely an L.A. Care provider close by. Search the L.A. Care Provider

Directory to

PAYMENTS | L.A. CARE HEALTH PLAN Create a member log-in and make your first payment through L.A. Care Connect. Mail a check or money order to the L.A. Care Covered payment address or L.A. Care Covered Direct payment address: L.A. Care Health Plan. L.A. Care Covered ™. P.O. Box 741507. Los Angeles, CA 90074-1507. L.A. Care Health Plan. L.A. Care Covered ™ Direct. L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed. COMMUNITY RESOURCE CENTERS Building Active, Healthy, & Informed Communities. Our resource centers are open to members and the general public. Get access to a variety of health care and community resources. We invite you to make an appointment today by calling 1-877-287-6290 so that our staff can help you receive the services you need. We’re back and ready to serve

you!

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HEALTHY LIVING & PREVENTION L.A. Care’s Health in Motion™ program helps you reach your health goals with our experienced staff of Certified Health Coaches and Registered Dietitians. We help L.A. Care members: Online through L.A. Care Connect - your personal member account. Over-the-phone with a Certified Health Coach at 1-855-856-6943. In your neighborhood at one

of

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A.

Care

PAY-FOR-PERFORMANCE (P4P) PROGRAM Welcome to L.A. Care Health Plan’s Physician Pay-for-Performance (P4P) Program. The Physician P4P program offers performance-based incentives to qualified high-volume physicians and higher-volume Community Clinics that provide high-quality preventive and chronic care to L.A. Care members. Eligibility This program is open to: Solo and small group physicians with 250 or more assigned L.A. Care HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HOME | L.A. CARE HEALTH PLANHEALTH PLANSFOR MEMBERSFOR PROVIDERSHEALTHY LIVINGCONTACT USFIND A DOCTOR Health Care Coverage. 1-888-4LA-CARE (1-888-452-2273)Provider Information. 1-866-LACARE6 (1-866-522-2736)Member Services. 1-888-839-9909 (TTY 711) 24 hours a day. L.A. Care Covered/Direct Member Services. 1-855-270-2327 (TTY 711). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

L.A. CARE CONNECT

Welcome to L.A. Care Connect. L.A. Care Health Plan has enabled 2 Factor Authentication effective March 10, 2021, for all members who wish to create an account or who simply want to login to the Member Portal. Members must now enter an email address or a text message compatible cell phone number to request a 6 digit security code in

order to

L.A. CARE SIGN-IN

Sign-In. Enter your username and password to login. This system and program are the property of L. A. Care Health Plan and can be accessed only by authorized users for authorized business purposes only. Unauthorized use of this system and/or program is strictly prohibited; and the user may be subject to fines and/or criminal prosecution. L.

A.

MAKING A PAYMENT

If you are making your first premium payment, you can: Create a member log-in and make your first payment through L.A. Care Connect, Mail a check or money order to the address provided, or. Call our Member Services Department at the toll free number 1-855-270-2327 (TTY/TDD

711) to

L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed.

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

REQUEST A FACE MASK

Request a Face Mask. L.A. Care would like to provide you with a face mask. Please complete the form below and allow 7-10 business days for

delivery.

FAMILY RESOURCE CENTERS L.A. Care's Family Resource Centers offer free health and wellness classes in three communities across Los Angeles County: Boyle Heights, Inglewood and Pacoima. Join a class to learn about nutrition, talk about parenting, share caregiving challenges or dance your stress away! Classes are free and open to L.A. Care members and the entire

community.

FIND A PROVIDER

Network of Providers. We’re making health care easier to access. With a network of over 60 hospitals, 3,000 physicians and 1,600 pharmacies — including CVS and Rite Aid stores — there's most likely an L.A. Care provider close by. Search the L.A. Care Provider

Directory to

PAYMENTS | L.A. CARE HEALTH PLAN Create a member log-in and make your first payment through L.A. Care Connect. Mail a check or money order to the L.A. Care Covered payment address or L.A. Care Covered Direct payment address: L.A. Care Health Plan. L.A. Care Covered ™. P.O. Box 741507. Los Angeles, CA 90074-1507. L.A. Care Health Plan. L.A. Care Covered ™ Direct. L.A. CARE PROVIDER PORTAL Login. Session Logoff. You are about to be logged out due to inactivity. You are now leaving the L.A. Care Website. The information, content, services or products on the website is offered through "L.A. Care's Plan Partners" and/or service providers. Proceed. COMMUNITY RESOURCE CENTERS Building Active, Healthy, & Informed Communities. Our resource centers are open to members and the general public. Get access to a variety of health care and community resources. We invite you to make an appointment today by calling 1-877-287-6290 so that our staff can help you receive the services you need. We’re back and ready to serve

you!

VISION SERVICES

As a Member of L.A. Care Cal MediConnect Plan you are covered for a variety of Vision services including: One (1) routine eye exam every year, Up to $200 for eyeglasses (frames and lenses) or up to $200 for contact lenses every two years. The plan will pay for outpatient doctor services for the diagnosis and treatment of diseases and

injuries

HEALTHY LIVING & PREVENTION L.A. Care’s Health in Motion™ program helps you reach your health goals with our experienced staff of Certified Health Coaches and Registered Dietitians. We help L.A. Care members: Online through L.A. Care Connect - your personal member account. Over-the-phone with a Certified Health Coach at 1-855-856-6943. In your neighborhood at one

of

TRANSPORTATION SERVICES This benefit allows for transportation that is the most cost effective and accessible. Call L.A. Care Member Services at 1-888-839-9909 (TTY 711) to learn more about your transportation options and how to schedule a ride. Transportation services that are available to L.A.

Care

PAY-FOR-PERFORMANCE (P4P) PROGRAM Welcome to L.A. Care Health Plan’s Physician Pay-for-Performance (P4P) Program. The Physician P4P program offers performance-based incentives to qualified high-volume physicians and higher-volume Community Clinics that provide high-quality preventive and chronic care to L.A. Care members. Eligibility This program is open to: Solo and small group physicians with 250 or more assigned L.A. Care

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* Testing, Testing - 1, 2, 3! * Benefits & Assistance L.A. CARE _COVERED_ ™ L.A. Care is proud to participate in Covered California™ to offer affordable health insurance to Los Angeles County residents.

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NEED MEDICATION, BUT HAVE TO STAY HOME? TRY MAIL ORDER! Order online to get a 90-day supply of your prescriptions delivered

for free.

See How

STAYING HEALTHY WHILE STAYING AT HOME Our Resource Centers are now providing on-demand health classes.

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COVERED CALIFORNIA EXTENDS ENROLLMENT PERIOD Covered California extends enrollment period to June 30 due to

COVID-19 pandemic.

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L.A. CARE COMMUNITY LINK IS HERE FOR YOU Search for free social services assistance for housing, food, bills

and more.

Search Now

A 24/7 OPTION FOR URGENT CARE Talk to a doctor by phone or video chat using L.A. Care's new

telehealth benefit.

Learn How

NEED MEDICATION, BUT HAVE TO STAY HOME? TRY MAIL ORDER! Order online to get a 90-day supply of your prescriptions delivered

for free.

See How

STAYING HEALTHY WHILE STAYING AT HOME Our Resource Centers are now providing on-demand health classes.

Learn More

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Need help selecting a health plan? We are here for you. Help Me

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FIND A DOCTOR OR HOSPITAL Search near your work or home for a hospital or a doctor who speaks

your language.

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FAMILY RESOURCE CENTERS ARE TEMPORARILY CLOSED DUE TO COVID-19. Learn more about how to stay healthy by visiting our coronavirus

page.

JOIN US FOR CLASSES AT OUR FAMILY RESOURCE CENTERS All of our classes and services are free and open to L.A. Care members

and the community.

Choose Location

* Boyle Heights Los Angeles, California * East L.A. Los Angeles, California * Inglewood Inglewood, California * Lynwood Lynwood, California * Pacoima Pacoima, California * Palmdale Palmdale, California * Pomona Pomona, California

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LATEST NEWS

May 14, 2020

INLAND EMPIRE HEALTH PLAN (IEHP)... Two of California's largest publicly operated...

May 13, 2020

L.A. CARE LEADS A SECOND PUSH FOR... Twenty-six health plans from across the country...

May 12, 2020

HOW L.A. CARE HEALTH PLAN... (LINK IS EXTERNAL) L.A. Care's Director of Business Process...

May 6, 2020

JOHN BAACKES ON COVID-19 AND... Zetema Project released a YouTube clip featuring...

More Latest News

UPCOMING EVENTS

May 19, 2020

CHILDREN'S HEALTH CONSULTANT ADVISO... Children's Health Consultant Advisory Committee...

May 21, 2020

COMPLIANCE & QUALITY COMMITTEE MEETI... Compliance & Quality Committee Meeting

May 22, 2020

L.A. CARE, CAL MEDICONNECT, VIRTUAL TOWN... Join L.A. Care Health Plan at the upcoming...

May 26, 2020

EXECUTIVE COMMITTEE MEETING Board of Governors Meeting More Upcoming Events Have Questions? Contact us .

HEALTH COVERAGE

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L.A. Care Health Plan, A Public Entity ©2000-2020

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HEALTH CARE COVERAGE 1-888-4LA-CARE (1-888-452-2273 ) PROVIDER INFORMATION 1-866-LACARE6 (1-866-522-2736 )

MEMBER SERVICES

1-888-839-9909 (TTY 711) 24 hours a day L.A. CARE COVERED/DIRECT MEMBER SERVICES 1-855-270-2327  (TTY 711) L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

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LANGUAGE ASSISTANCE SERVICES

English & ASL

Español - Spanish

عربي - Arabic

Հայերեն - Armenian

中文 - Chinese

فارسی - Farsi

हिंदी - Hindi

Hmong - Hmong

日本語 - Japanese ខ្មែរ - Khmer

한국어 - Korean

ລາວ - Lao

ਪੰਜਾਬੀ - Punjabi Русский - Russian

Tagalog - Tagalog

ภาษาไทย - Thai tiếng Việt - Vietnamese

ORIGINAL TEXT

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