Choosing a Health Plan

In the U.S. today, most people with health insurance have some type of managed care plan. There are different types of managed care plans but they all involve an agreement that the patient will use certain healthcare providers or clinics within those programs’ network.  After refugees choose a managed care company, that company will give them a list of healthcare providers who are members of its plan.  They choose a doctor from this list, and that doctor becomes their primary care doctor (PCD).  If refugees do not choose a doctor, the company will choose one for them.  The primary care doctor is in charge of “managing” the refugees’ health care.

One of the rules of managed care is that a person must always go to their primary care doctor first, unless it is a life-threatening emergency.  Refugees should go to their primary care healthcare provider when sick, when in need of immunizations, or for treatment of a continuing health problem.  If a primary care doctor wants a refugee to see another doctor with advanced knowledge and training, the doctor will send them to a specialist.  The health care plan will not pay for a refugee to see a specialist unless they have a referral from a primary care doctor.  It is important to learn which services the health care company will pay for.  It is also important to follow all the rules so the company will pay for health services.

Choosing a Managed Care Plan:

Ask for written information, talk to a Medi-Cal contact person, or ask friends and family about which plan they like.  Below is a link to find approved Medi-Cal plans in your county:  Medi-Cal Plans

You may choose your health plan or change your health plan at any time, and in a number of ways. You can make a choice by calling California Health Care Options:

Learn about all the choices so that you can make a good decision about what is best for you and your family.  Here are some good questions to ask when you are choosing a managed care plan:

• Do the healthcare providers in the plan speak my language?

•  Are the plan’s healthcare providers and hospital near my house?

•  Does public transportation go to these places?

•  Do I have to make co-payments and how much are they?

•  Can I change my doctor if I want to?

Choose a primary care doctor as soon as you have received your Medi-Cal card.  Call the healthcare provider’s office and make an appointment for you and your family even if you feel well.  It is important for you and your family to know your primary care doctor.