General Information

How do I qualify for SelectCare?

SelectCare was specifically designed for persons who are dually eligible for Medi-Cal and Medicare. "Dually eligible" means that you are entitled to both Medi-Cal and Medicare programs. You must be fully Medi-Cal eligible with no share of cost and entitled to Part A and enrolled in Medicare Part B to be a member of SelectCare. You must reside in Contra Costa County and use our provider networks for all of your routine care.

Will I have to pay any premium to join CCHP's SelectCare plan?

Under SelectCare, there is no Part C premium for your plan benefits. There is a $22.60 plan premium each month for your Medicare Part D prescription benefits. However, since you qualify for the Low-Income Subsidy (LIS) because you have Medicare and full Medi-Cal benefits, Medicare will pay $22.60 for your monthly Part D premium. You will be responsible for the remaining $0.00 Part D premium each month. This premium includes all covered medical and prescription drug benefits.

If I join CCHP's SelectCare Medicare Advantage plan, what benefits will I have?

Member SelectCare receive all of the benefits that the Original Medicare Plan offers. We also offer Medi-Cal benefits you are eligible for. CCHP's believes SelectCare provides an opportunity to better integrate care to dual eligibles. We offer the full array of Medicare and Medi-Cal benefits through SelectCare so that you have a single benefit package and one set of providers to obtain the care you need. We also provide care coordination and integration of services. Detailed information can also be found in the SelectCare Summary of Benefits and Evidence of Coverage.

Does SelectCare cover Medicare Part B or Part D drugs?

SelectCare does cover both Medicare part B prescriptions drugs and Part D prescriptions drugs.

Does SelectCare have a Prescription Drug Formulary?

SelectCare uses a formulary. A formulary is a preferred list of drugs-selected to meet patient needs. The plan may periodically make changes to the formulary. If the formulary changes, affected enrollees will be notified in writing before the change is made.

Where can I get my prescriptions if I join this plan?

SelectCare has formed a network of pharmacies. You can use any pharmacy in our network.

Can I choose my doctors?

SelectCare has two networks of doctors, specialist, and hospitals. See our Provider Directory (PDF).

You will choose a Primary Care Provider (PCP) and get your care from the network where your PCP is located. Your PCP will help coordinate all of your care and can guide you to Plan specialists when needed.

Can I go to a doctor who is not in my Network?

With the exception of Urgent, Emergent or Out-of-Area renal dialysis care, if you choose to go to a doctor outside your PCP network without prior authorization from CCHP, you must pay for these services yourself. Neither CCHP nor Original Medicare Plan will pay for these services.

Will I have to pay any copayments?

The only co-payments will be for prescriptions drugs covered by Part D. You will pay $1.05 or $2.25 for a covered generic drug and $3.10 or $5.60 for a covered brand name drug. If you are admitted to a Skilled Nursing Facility you will have $0.00 drug copayments.