Frequently Asked Questions (FAQ)

Provider assignments are based on the Department of Health Care Services (DHCS) enrollment file. If no plan is chosen within 30 days of you getting the Health Care Options (HCO) packet, DHCS will assign a plan and select a Primary Care Physician (PCP) for you.

You can confirm your Physician Group and PCP by checking the front side of your Member ID card. If you’d like to change your doctor, you can submit a request through the CalViva Health Member website: Change Your Doctor – CalViva Health. Or, you can contact Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week.

You can check if your PCP is in-network by visiting the CalViva Health Member Website at Find A Provider – CalViva Health. You can also call the Member Services Department toll-free at 1-888-893-1569 (TTY: 711), 24 hours a day, 7 days a week. A Member Services Representative can help you find an in-network provider that fits your preferences and healthcare needs.

The new member Welcome Kit includes details on how to choose and confirm your preferred PCP.

ID cards are typically mailed within 7 business days from the date of enrollment or the date the ID card was requested. Please allow more time for mailing.

If it’s been more than 7 business days, please contact CalViva Health Member Services Department toll-free at 1-800-893-1569 (TTY:711) 24 hours a day, 7 days a week. A representative can confirm your status and issue a new card if needed.

You can sign up on the CalViva Health Member Portal to access your ID card and print it instantly. There is no cost to sign-up. To sign up you must have your Member ID number. If you do not know your Member ID number or do not have access to a computer or have questions, please call CalViva Health Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week.

All CalViva Health members have routine vision benefits. You will find vision information in your new member Welcome Kit and Member Handbook.

Need help finding a vision provider? Call CalViva Health Member Services toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week. A Member Services Representative will assist you or transfer you to a vision specialist.

You can find routine vision benefit information in your new member Welcome Kit and Member Handbook.  Benefits typically include:

-Contact lenses

-Eye exams

-Glasses

Routine dental benefits typically include preventive services such as:

• Cleanings
• Exams
• X-rays

Please note Dental benefits and services are covered under Fee for Service (FFS) Medi-Cal Dental. Before you get dental services, you must show your Medi-Cal BIC card to the dental provider. Make sure the provider takes FFS Dental.

You can find Dental Benefit information in your new member Welcome Kit and Member Handbook. These materials are also available online at: https://calvivahealth.org/benefits/member-resources/

For questions or to learn more about dental benefits and services, call CalViva Health Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week.

For more information, you can also call Medi-Cal Dental:

Online: https://www.dental.dhcs.ca.gov

Call (toll-free) 1-800-322-6384 (TTY:711) Monday–Friday 8 a.m. to 5 p.m.

CalViva Health members have dental coverage through Medi-Cal Dental. Please refer to your Dental ID card for help making an appointment.

Details are listed in your Welcome Kit and Member Handbook. These materials are also available online at: https://calvivahealth.org/benefits/member-resources/

For assistance to access routine dental benefits, call CalViva Health Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week.

For more information or to contact Medi-Cal Dental:

Online: https://www.dental.dhcs.ca.gov.

Call (toll-free) 1-800-322-6384 (TTY: 711) Monday–Friday 8 a.m. to 5 p.m.

Details about your dental benefits are available in your new member Welcome Kit in the “Healthy Smiles Start Here” section also available online at: https://calvivahealth.org/benefits/member-resources/

For more information about dental benefits, call CalViva Health Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week.

For more information or to contact Medi-Cal Dental:

Online: https://www.dental.dhcs.ca.gov.

Call (toll-free) 1-800-322-6384 (TTY: 711) Monday–Friday 8 a.m. to 5 p.m.

Your CalViva Health Medi-Cal plan covers rides when you need healthcare and services. This is also known as routine medical transportation. Members can access two types of transportation services for medical appointments.

Non-Emergency Medical Transportation (NEMT)  is transportation by ambulance, wheelchair van, or litter van for those who cannot use public or private transportation.

 Non-Medical Transportation (NMT)  is transportation by private or public vehicle for people who do not have another way to get to their appointment.

Call CalViva Health Member Services Department toll-free at 1-888-893-1569 (TTY: 711) 24 hours a day, 7 days a week. Contact details are also listed in your new member Welcome Kit, Member Handbook, and in the member Transportation Services Guide.

Please refer to your transportation booklet, “How to get a ride for Healthcare Services” in your new member Welcome Kit. The booklet contains helpful information that includes:

• The types of rides you can schedule
• What you need to reserve a ride
• Tips on how to use transportation services

You can also access the Member Transportation Services Guide on the CalViva Health website. Go to www.CalVivaHealth.org/benefits/member-resources/ and scroll down to Member Transportation Services Guide.