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CHOC Health Alliance

CHOC Health Alliance

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Members – Frequently Asked Questions

How do I call the Member Services Department?

You can call us toll free at 1-800-424-CHOC (2462).

Can my child enroll in a different health network than me?

Yes, CalOptima members can now choose different health networks for different family members. This means your children up to age 21 can continue getting their health care services through CHA and you can be in another health network.

What do I do if I lost my child’s ID card?

For the Medi-Cal Beneficiary Identification Card (BIC), call your local County of Orange Social Services Agency.
For the CalOptima card, call the CalOptima Customer Service Department toll free at 1-888-587-8088.
For the CalOptima Kids card, call the CalOptima Kids Member Services Department toll free at 1-800-530-2899.

My child is assigned to a Primary Care Physician (PCP) I did not choose. Can I change his/her PCP?

If you did not choose a PCP on the CalOptima Selection Form, CHOC Health Alliance will assign your child a PCP close to your home. You may change your child’s PCP every 30 days. To do so, call our Member Services Department.

What do I do if my child needs to see a specialist or needs special medical services?

You can ask your PCP for a referral. Your PCP will work with CHOC Health Alliance to get approval.

What do I do if I get billed for health care services?

You should first call the provider who is billing you. This should be the same provider who provided care to your child. You should give this provider your child’s CHOC Health Alliance Medi-Cal information. You should then call CHOC Health Alliance for further assistance or use the Contact Us page located on our website.

What if my child has other health insurance?

The other health insurance will be the primary payer responsible for covering the services your child needs and/or receives. CHOC Health Alliance will be the last payer. You will need to seek payment for services through your child’s primary insurance before CHOC Health Alliance pays.

What if my child needs care when he/she is outside of Orange County?

If your child is outside of Orange County and has an emergency, go to the nearest hospital emergency room. Show the hospital staff your child’s CalOptima and/or BIC card and identify your child as a CHOC Health Alliance member. Ask the hospital staff to call CHOC Health Alliance within 24 hours. If you are not sure if it is an emergency, call your child’s PCP first. Do not use the emergency room for routine care!

What if I need care after hours?

If you have an emergency situation, go to the nearest emergency room or call 9-1-1.
Urgent care is medical care needed for sudden illness or injury that cannot wait for a regular office visit. If your child has an urgent situation, call your child’s PCP first.  If you cannot reach your PCP, call CHOC Health Alliance.

Who do I call for dental care?

As a Medi-Cal member, your child can go to any dentist who takes Medi-Cal. You can call Denti-Cal toll free at 1-800-322-6384 for a list of dentists.

Call CalOptima Kids at 1-800-530-2899 to find out your dental plan.

Where do I call for mental health services?

As a Medi-Cal member, your child can get most mental health benefits through CalOptima Mental Health Plan. To get these services, call toll-free 1-855-877-3885.

You may self-refer to a participating behavioral health provider of your choice for an initial face-to-face assessment.

What type of transportation is available?

Emergency transportation is available to CHOC Health Alliance members when the member’s medical conditions are life threatening. Non-emergency transportation will require approval in advance from CHOC Health Alliance. You should call your PCP to schedule transportation service.

Can I talk to the doctor in my own language?

Yes. As a CHOC Health Alliance member, you can get free interpreter services when you have a doctor’s appointment. You can also ask to have an interpreter assist you when you call CHOC Health Alliance. This includes sign language interpreters. Call our Member Services Department toll free at 1-800-424-2462 for more information.

Who do I report my change of address or name to?

Call the County of Orange Social Services Agency and/or the U.S. Social Security Administration to report any changes such as name, telephone number and/or address.

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