Navigating healthcare plans can be confusing, especially when you’re looking for the right care at UC San Diego Health. If you have Medi-Cal or a Dual-Eligible Medicare/Medi-Cal plan, understanding your coverage for primary care and specialty services is essential. Let’s clarify how these plans work at UC San Diego Health, particularly focusing on plans like SCAN.
Medi-Cal Plans Accepted at UC San Diego Health
UC San Diego Health is committed to serving patients with various Medi-Cal plans. We accept Medi-Cal fee-for-service and work with the following managed care plans for specialty referrals. It’s important to note that primary care access is generally limited under most of these Medi-Cal plans at our facilities.
Here’s a breakdown of Medi-Cal plans where UC San Diego Health provides specialty care referrals only:
- Medi-Cal FFS – specialty referrals only, no primary care access
- Anthem Blue Cross AIM (Access for Infants and Mothers) HMO
- Blue Shield Promise Medi-Cal HMO (formerly Care 1st) – specialty referrals; primary care limited to HIV patients only
- Community Health Plan of Imperial Valley – specialty referrals only, no primary care access
- CalOptima – specialty referrals only, no primary care access
- Community Health Group (CHG) Medi-Cal HMO – specialty referrals only, no new primary care except pediatric patients through UCSD Pediatrics Associates
- Health Net – specialty referrals only, no primary care access
- Inland Empire Health Plan – specialty referrals only, no primary care access
- Molina Medi-Cal – specialty referrals only, no primary care access
Exception for Pediatric Primary Care: If you are seeking primary care for pediatric patients under Community Health Group (CHG) Medi-Cal HMO, access is available through UCSD Pediatrics Associates.
Dual-Eligible Medicare/Medi-Cal Plans (formerly MediConnect)
For individuals eligible for both Medicare and Medi-Cal, UC San Diego Health contracts with several managed care plans. These plans, previously known as MediConnect, also primarily offer specialty care services at UC San Diego Health, often requiring referrals and authorizations.
Is Prime Care Under Scan Connections Cal MediConnect? Similar to other Dual-Eligible plans we accept, SCAN Connections Cal MediConnect provides access to specialty services only at UC San Diego Health, with a necessary referral and authorization from your provider or SCAN. Primary care access is not available through SCAN Connections Cal MediConnect at UC San Diego Health facilities.
Here are the Dual-Eligible plans we contract with:
- Anthem MediBlue Coordination Plan Plus HMO – specialty referrals only, no primary care
- Blue Shield Total Dual D-SNP – specialty care only, with a referral and authorization from their provider or Blue Shield. No primary care access. For more information, call Blue Shield at 800-709-1333.
- SCAN Connections Cal MediConnect – specialty services only with a referral and authorization from their provider or SCAN. No new primary care access
- Community Health Group (CHG) CommuniCare Advantage Cal MediConnect – specialty referrals only, no new primary care
- CalOptima – specialty referrals only, no primary care access
- Molina Dual Options Cal MediConnect – specialty referrals only, no primary care access
Important Note: UC San Diego Health (UCSD Medical Center) and UC San Diego Medical Group are in-network with most major insurance plans. If your plan isn’t listed and you need specialty care, consult your primary care physician to request a specialty service authorization to UC San Diego Health. For specific details about your coverage and prime care options under plans like SCAN, it’s always best to contact your insurance provider directly.
