2020 Plan Information

The information provided here is intended to be a summary of our plan, effective January 1, 2020.

  • Annual Notice of Changes (ANOC) (English)
  • Annual Notice of Changes (ANOC) (Spanish)_pending
  • Annual Notice of Changes (ANOC) (Arabic)_pending
  • Annual Notice of Changes (ANOC) (Vietnamese)_pending
  • Annual Notice of Changes (ANOC) (Tagalog)_pending
  • Member Handbook - Evidence of Coverage (EOC) (English)
  • Member Handbook - Evidence of Coverage (EOC) (Spanish)_pending
  • Member Handbook - Evidence of Coverage (EOC) (Arabic)_pending
  • Member Handbook - Evidence of Coverage (EOC) (Vietnamese)_pending
  • Member Handbook - Evidence of Coverage (EOC) (Tagalog)_pending
  • Combined Pharmacy/Provider Directory-English
  • Combined Pharmacy/Provider Directory (Spanish)_pending
  • Combined Pharmacy/Provider Directory (Arabic)_pending
  • Combined Pharmacy/Provider Directory (Vietnamese)_pending
  • Combined Pharmacy/Provider Directory (Tagalog)_pending
  • List of Covered Drugs (Formulary) (English)
  • List of Covered Drugs (Formulary) (Spanish)_pending
  • List of Covered Drugs (Formulary) (Arabic)_pending
  • List of Covered Drugs (Formulary) (Vietnamese)_pending
  • List of Covered Drugs (Formulary) (Tagalog)_pending
  • Pharmacy Prior Authorization Criteria (English)_pending
  • Pharmacy Step Therapy Criteria (English)_pending
  • Summary of Benefits (English)
  • Summary of Benefits (Spanish)_pending
  • Summary of Benefits (Arabic)_pending
  • Summary of Benefits (Vietnamese)_pending
  • Summary of Benefits (Tagalog)_pending
  • Drug Transition Policy (English)_pending 

Forms

 

Additional Member Resources

Please click on the following link to access Centers for Medicare & Medicaid Services website:

www.cms.gov

 

Please click on the following link to access the Medicare and You Handbook:

Medicare and You Handbook

 

Please click on the following link to obtain information on help with prescription drug costs:

https://www.ssa.gov/benefits/medicare/prescriptionhelp/

 

Disclaimers

CommuniCare Advantage Cal MediConnect Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.


English

ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Call: Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584).

Español (Spanish)

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al: Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584).

Tiếng Việt (Vietnamese)

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số: Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584).

Tagalog (Tagalog - Filipino)

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa: Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584).

العربیة (Arabic)

ملحوظة: اذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة  اللغوية تتوافر لك بالمجان. اتصل برقم

Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584).

 

Last update 09/30/2019
H5172_Website2020