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Affordable CalOptima Health Insurance
Founded in 1995 as a County Organized Health System (COHS), CalOptima administers Medi-Cal benefits to over 290,000 residents of Orange County, California. The federal government has authorized this COHS to oversee this healthcare program. CalOptima has greatly improved the ease of access to the healthcare provided by eleven health networks for those beneficiaries. The company also administers Orange County's Healthy Families Program. Governed by a private board of directors, and in close partnership with providers and advocacy groups, it has developed a new benchmark for Medicaid managed care programs.
CalOptima Coverage
CalOptima1120 West La Veta Avenue
Orange, CA 92868
http://www.caloptima.com
CalOptima controls three countywide programs, including:
- The supervision of the Medi-Cal benefits, and the contracted services of 3,500 primary care physicians.
- The supervision of CalOptima Kids, a Healthy Families Program, formed for California families who earn too much to be eligible for Medi-Cal, but who cannot pay for private medical insurance.
- The supervision of OneCare, a program that simplifies healthcare for Orange County residents eligible for both Medicare and Medi-Cal.
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Some of the features of the CalOptima plans are as follows:
- An emphasis on preventive healthcare services for all members of the family.
- Family planning services
- Maternity care and newborn care services
- Referrals for specialty care
- Hospital care
- Nursing facility services
- Hospice care
- Lab services
- Immunizations
- Emergency care
- Vision, hearing, speech, physical and occupational therapy services
- Transportation to medical services for patients who cannot use ordinary public or private transportation.
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CalOptima strives to provide the best possible managed healthcare for its members, including many special needs groups. The company is achieving its goals with sensitivity, innovation, and cost-effective efficiency.
