More than 9,000 Medi-Cal beneficiaries will return to Gold Coast Health Plan for administration of their benefits
CAMARILLO — Gold Coast Health Plan’s (GCHP) partnership with AmericasHealth Plan (AHP) is expected to end on March 31, 2023, following a recent notification from Clinicas del Camino Real about its business decision to wind down operations of AHP, a wholly owned subsidiary. As such, GCHP will end its three-year subcontract with AHP after 18 months and transition the health care administration of more than 9,000 Medi-Cal beneficiaries back to GCHP on April 1, 2023. Member benefits and services will not be affected by the transition. Members who have an assigned primary care provider will be able to continue with that provider or select a new one.
The state Department of Health Care Services (DHCS), the regulatory agency that oversees GCHP, is reviewing the proposed transition plan. GCHP will begin notifying members about the health plan change by phone and mail immediately.
“We will be working closely with the leaders from Clinicas del Camino Real to ensure a seamless transition for these members and the providers who care for them,” said Nick Liguori, GCHP’s chief executive officer. “Our top priority is to prevent any interruptions to their care.”
GCHP announced its partnership with AHP on Sept. 13, 2021, for a pilot program that would give up to 10,000 of its members the option of choosing AHP as the administrator of their health care benefits. Members who were interested in participating in the program opted in by providing their written consent to GCHP.
Members who have questions about the transition can call GCHP Member Services at 1-888-301-1228, Monday through Friday, from 8 a.m. to 5 p.m. Those who use a TTY should call 711. Members can also call the Medi-Cal Office of the Ombudsman at 1-888-452-8609, Monday through Friday, from 8 a.m. to 5 p.m.
About Gold Coast Health Plan — Gold Coast Health Plan proudly serves more than 250,000 Medi-Cal beneficiaries in Ventura County through its network of primary care physicians, specialists, behavioral health providers, and hospitals. Since it was founded in 2011, Gold Coast Health Plan has been committed to providing access to high-quality care and improving the health of its members, which include 1 in 3 county residents, 1 in 6 seniors, and 1 in 2 children up to the age of 5. To learn more, visit: www.goldcoasthealthplan.org
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Finaliza la Colaboracio?n de Gold Coast Health Plan con AmericasHealth Plan
Ma?s de 9,000 beneficiarios de Medi-Cal volvera?n a Gold Coast Health Plan para la administracio?n de sus beneficios
CAMARILLO – – Esta? previsto que la colaboracio?n de Gold Coast Health Plan (GCHP) con AmericasHealth Plan (AHP) finalice el 31 de marzo de 2023, tras la notificacio?n reciente por parte de Clinicas del Camino Real de su decisio?n comercial de liquidar las operaciones de AHP, una filial totalmente de su propiedad. De este modo, GCHP finalizara? su subcontratacio?n de tres an?os con AHP despue?s de 18 meses y hara? la transicio?n de ma?s de 9,000 beneficiarios de Medi-Cal de vuelta a GCHP el 1 de abril de 2023. Los beneficios y servicios para miembros no se vera?n afectados por la transicio?n. Los miembros que tengan un proveedor de atencio?n primaria asignado podra?n seguir con ese proveedor o seleccionar uno nuevo.
El Departamento estatal de Servicios de Salud (DHCS), la agencia reguladora que supervisa a GCHP, ha aprobado el plan de transicio?n propuesto. GCHP comenzara? inmediatamente a avisar por tele?fono y por correo a los miembros sobre el cambio de plan de salud.
“Trabajaremos estrechamente con la direccio?n de Clinicas del Camino Real para garantizar una transicio?n fluida para estos miembros y los proveedores que cuidan de ellos”, dijo Nick Liguori, director ejecutivo de GCHP. “Nuestra prioridad nu?mero uno es impedir cualquier interrupcio?n en su atencio?n.”
GCHP anuncio? su colaboracio?n con AHP el 13 de septiembre de 2021, para un programa piloto que dari?a hasta a 10,000 de sus miembros la opcio?n de escoger a AHP para que administrase sus beneficios de atencio?n de salud. Los miembros que estuvieron interesados en participar en el programa optaron incorporarse proporcionando a GCHP su consentimiento por escrito.
Los miembros que tengan preguntas sobre la transicio?n pueden llamar al Departamento de Servicios para Miembros de GCHP al 1-888-301-1228, de lunes a viernes, de 8 a.m. a 5 p.m. Aquellos que usen un TTY deben llamar al 711. Los miembros tambie?n pueden llamar a la Oficina del Defensor del Cliente de Medi-Cal al 1-888-452-8609, de lunes a viernes, de 8 a.m. a 5 p.m.
Acerca de Gold Coast Health Plan — Gold Coast Health Plan se enorgullece en brindar servicio a ma?s de 250,000 beneficiarios de Medi-Cal en el Condado de Ventura, a trave?s de su red de me?dicos de atencio?n primaria, especialistas, proveedores de salud del comportamiento y hospitales. Desde su fundacio?n en 2011, Gold Coast Health Plan mantiene su compromiso con dar acceso a una atencio?n de alta calidad y con mejorar la salud de sus miembros, entre los que se incluyen 1 de cada 3 residentes del condado, 1 de cada 6 adultos mayores, y 1 de cada 2 nin?os hasta los 5 an?os. Para obtener ma?s informacio?n, visite la pa?gina www.goldcoasthealthplan.org