CalOptima OneCare Connect
Welcome to AltaMed! Thank you for choosing us for your health care services. We are happy to work with you on all of your health care needs.
As a member of AltaMed, you need to make an appointment to see your Primary Care Provider (PCP). Your first visit will help your doctor understand your health care needs.
The following information lists specific services offered by AltaMed under the OneCare Connect plan. If you have any questions, please contact our Member Services Department toll-free 1-866-880-7805, Monday through Friday, from 8:00am to 5:30pm. TTY users can call 1-800-735-2929.
- Services Offered
- Service Area by Zip Code
- AltaMed Orange County Clinic Locations
- Language Access Services
- Emergency Services
- Prior Authorization Rules
- Out-of-Network Coverage
- Quality Promise: Policies and Procedures
- Patient's Disenrollment Rights and Responsibilities
- Contract Termination
CalOptima OneCare Connect Resources
Other formats, such as large print, Braille and audio CD are available upon request. Call us for assistance with reading or understanding the materials you receive from us.
In the case of an emergency, you do not need to get prior authorization from your primary care provider. You should call 911 directly or visit the nearest ER.
Prior authorization is an approval for special medical services given by AltaMed. These services include:
- Specialty care
- Inpatient and outpatient hospital care
- Ancillary care, such as home health care
- Medical supplies
- Durable medical equipment (DME)
- Non-emergency medical transportation
General Response Time for Prior Authorizations
- Routine authorizations: Five working days (Commercial/Medi-Cal), Fourteen working days (Senior)
- Urgent authorizations: 72 hours
Your doctor and Altamed will decide if you need special medical services using evidenced-based criteria. Call AltaMed’s Customer Service Department at 1-866-880-7805 if you have questions about prior authorization.
You can get preventive care, basic prenatal care, family planning and emergency services without prior authorization. Women can see any women’s health specialist (such as an obstetrician/gynecologist or certified nurse midwife) within their health network for basic prenatal care, breast exams, mammogram and pap tests without a referral or prior authorization. You can call your women’s health specialist directly to make an appointment.
If covered health care services are not available within your network, out-of-network services may be approved. A prior authorization is required for non-emergency services. Your provider will submit an Authorization Referral Request.