Answers to Common Questions

contact membersThe following are some of the more frequently asked questions by our members. We hope you will find what you are looking for. If you still have questions, please reach out to us by calling or emailing Member Services.

Now that I have Medi-Cal, who is CenCal Health?

CenCal Health is your MediCal Managed Care health insurance plan for those who have Medi-Cal in Santa Barbara and San Luis Obispo counties. The local Department of Social Services determines your eligibility for Medi-Cal. Once you become eligible, you are automatically enrolled as a member of CenCal Health.

What will happen next?

 CenCal Health sends you a “new member packet” that includes your ID card and a handbook with information about how to use the health plan. Don’t throw the packet away! You may need to refer to it later. 

When you first become eligible for Medi-Cal, the State of California will send you a Medi-Cal Benefits Identification Card (BIC). The new BIC has State of California written on top and has pictures of poppy flowers. If you have been on Medi-Cal before or are currently on Medi-Cal your current BIC, which is a white card with blue writing, is still valid and will not be reissued unless you lose your card. Your BIC will be used by doctors and providers to verify your Medi-Cal eligibility.  You may be asked to show both your CenCal Health ID card and your BIC card when you go to medical appointments, so always carry them with you.

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What is a PCP and how do I find a doctor?

This is your main doctor who oversees your care and refers you to the other services you need. Your “new member packet” contains a Provider Directory, a list of doctors on our health plan, and a form for selecting a doctor. If you already see a doctor, let us know who it is. If you don’t have a doctor, you need to pick a one or you will be assigned to one. If you need help selecting a doctor, or if you ever want to change your PCP, you can call our Member Services Department.

What if I do not like my PCP or doctor?

It is important to have a good relationship with your PCP. Good health care needs a team effort between you and your doctor. If you would like to change to another PCP, call our Member Services Department and ask for help to change to a new PCP. You can request to change your PCP at any time. This change will be effective the first day of the next month.

What if I need emergency or urgent care?

Emergency services are covered any time you are inside or outside of the service area (Santa Barbara or San Luis Obispo Counties) and you believe you or your child need medical care immediately. Go to the nearest emergency room or call 911. If you need urgent care after hours, nights or weekends and you believe treatment should not wait until regular office hours that your Primary Care Physician is open, Urgent Care services are available. You can find them listed in your provider directory. 

What if I need to see a specialist?

When you need to see a specialist or get special services, your Primary Care Provider (PCP) will refer you to the specialist. If you think you should see a specialist and your PCP does not agree that you need a referral, you should discuss this with them. If you are still not satisfied after talking with your doctor, you can call a Member Services Representative to talk about your concerns and file a complaint and/or change to a new PCP. 

What can CenCal Health - Member Services do for me?

Member Services has staff who speaks English and Spanish who can help you with the following:

  • Select or change your Primary Care Provider (PCP).
  • Answer your questions about how to use CenCal Health.
  • Arrange for interpreter services or transportation for your medical appointment.
  • Get help if you receive a bill for covered services.
  • Find a pharmacy or help you get your medicine or medical supplies.
  • Solve a problem or take a complaint.

For more assistance, please see our Members Page or please call Member Services Monday-Friday, 8am-5pm at our toll-free number 1-877-814-1861. Or, if you cannot hear or speak well, please call California Relay at 711 or TTY: 1-833-556-2560.

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