Blue Shield of California Promise Health Plan
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Enrollment for Blue Shield Promise Medi-Cal is processed by Health Care Options (HCO). You may contact them directly at (800) 430-4263. HCO will mail you an enrollment packet that you will need to fill out and mail back to them. Once HCO receives your packet, it takes 15 to 45 days for you to become a member of Blue Shield Promise Medi-Cal.
If you need care from a specialist, your PCP doctor must approve these services before you receive them.
Behavioral Services are not a covered benefit under the plan. If you need to obtain these services you may contact the toll-free numbers provided below.
Medi-Cal members who require behavioral health services can contact the Department of Mental Health's Local 24 hour crisis line at:Los Angeles: (800) 854-7771
Contact Member Services. Our Member Service Department is available to assist you. Call us at (800) 605-2556, Monday through Friday, 8:00 a.m. to 6:00 p.m. Our staff is comprised of Member Representatives that speak English, Spanish, Chinese, Armenian and Russian, and can answer any questions that you may have in regards to your health plan benefits. If you speak another language Blue Shield Promise Medi-Cal can also assist you through the use of one of our translators.
Blue Shield Promise Medi-Cal ID Card. Call Member Services and they will issue you a new one. You should receive your new card within 7-10 business days.
PCP Change. As a member of Blue Shield Promise Medi-Cal, we want you to be comfortable with your assigned primary care doctor. Blue Shield Promise Medi-Cal has a large group of doctors for you to choose from. You may change your doctor by calling our Member Services Department at (800) 605-2556. A change of doctor can be requested at any time, but it can take up to 30 days for the change to take effect.
Update Address. Call Blue Shield Promise Medi-Cal. We will update your address and instruct you to contact your eligibility worker at the DPSS toll-free number, (866) 613-3777.
When you become a member of Blue Shield Promise Medi-Cal, you will receive a "Welcome Packet" within the first 7 days of eligibility. The "Welcome Packet" will include a welcome letter, Provider Directory, Evidence of Coverage, and your Blue Shield Promise Medi-Cal ID card.
You are covered for transportation services to all routine, specialty, laboratory, and dental medical appointments. Some restrictions may apply. Please call Blue Shield of California Promise Health Plan Transportation Department at (877) 433-2178 from 8:00am – 5:00pm., Monday through Friday, at least 24 hours in advance.
If you have an emergency when you are not in our service area, you can obtain emergency services at the nearest emergency facility (doctor's office, clinic or hospital). Emergency services do not require a referral or an okay from your PCP doctor.
It is important you always carry your Blue Shield Promise Medi-Cal ID card with you. If you think you have an emergency, call 911 or go to the nearest emergency room. If you need urgent care (when a condition, illness, or injury is not life threatening, but medical care is needed right away) call or go to your nearest urgent care center.
If you are a Medi-Cal member and eligible for Medicare, it is important that you know that Medicare, not Medi-Cal, is your primary insurance. Blue Shield of California Promise Health Plan also offers Medicare coverage; if you are interested in combining your benefits please call Member Services for more information on the additional benefits available.
You should not receive a bill for any covered services. If you do, please call Member Services at:(800) 605-2556
There are federal and state laws that protect the privacy of your medical records and personal health information. We protect your personal health information under these laws. Any personal health information that you give us when you enroll in this plan is protected. We will make sure that unauthorized people don't see or change your records. If you have questions or concerns about privacy of your personal information and medical records, please call Member Services.(800) 605-2556
Some services are not covered by Blue Shield Promise Medi-Cal but are still benefits available through Medi-Cal or another State program. Please call Member Services if you have any questions.
The following are non-covered services:
If you move outside of Los Angeles County but still live in California, call your eligibility worker at DPSS right away toll free at (866) 613-3777. Your eligibility worker can help you find out what Medi-Cal services are available in your new community.