Most Common Questions

Here are the questions that most people are asking.

Question	Answer
I have to wait 2 months, sometimes longer, to get an appointment with my primary doctor. Is there something I can do to get seen sooner?	If you are experiencing an emergency, go to the hospital or call 911. Some doctor's offices have urgent care and "after hours" clinics that may be helpful to you. You should also talk to your doctor directly about your concern. If you have insurance, you can contact the plan to see if there are other doctors you can see. Also, try scheduling follow-up appointments with your doctor several months in advance.
I have no insurance and need to see a doctor.	Follow the steps on the www.myhealthresource.org database to see what programs/services in your local area you quality for. If you do not quality for a government funded program, the next step is to look for a local county program or service. Thereafter, your next option is to look for a free or low cost clinic/doctor to get help. If you have a chronic illness, many disease foundations also provide information and resources.
I don't have insurance and I do not quality for Medi-Cal, what are my options?	There are several programs other than Medi-Cal that you may quality for. Search the MyHealthResource database www.myhealthresource.org for programs and services that you may qualify for and try the following eligibility finder: http://www.coverageforall.org/finder/index.php If you still don't quality for any programs, you will have to look for a free program through your county department of health or look for a free to low cost clinic/doctor.
My insurance does not cover the specialty care I need. What do I do?	You can ask the insurance provider to "contract out" with a specialty center that provides the care you need. That means that they can make a special agreement for you to be seen by a specialist or specialty center, since they do not provide the care. Contact the HMO Help Center for more information/help: HMO Help Center Call 1-888-HMO-2219 (1-888-466-2219) TDD: 1-877-688-9891 There is no charge for your call. The HMO Help Center is open 24 hours a day, 7 days a week. The HMO Help Center can provide help in many languages.
My insurance has denied a procedure. What do I do?	Ask for an appeal (review). Also, ask your primary doctor to submit reason(s) why the procedure is important and should be covered by the insurance. Keep a log of all your conversations with the insurance and your doctor regarding the procedure. Write down names, dates and times of the people you talk to. For more help contact the HMO Help Center: Call 1-888-HMO-2219 (1-888-466-2219) TDD: 1-877-688-9891 There is no charge for your call. The HMO Help Center is open 24 hours a day, 7 days a week. The HMO Help Center can provide help in many languages.