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Gender Health - Gender Health
rse population of the Inland Empire has been estimated at almost 27,000 people. At Inland Empire Health Plan (IEHP), we want you to get all the care you need with the respect you deserve. IEHP covers all medically necessary Medi-Cal covered Gender Health services. IEHP has Doctors and Specialist who have experience in gender health services. To find out more information, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. How to Get Started See your IEHP PCP on a regular basis. If you have not seen your Doctor yet or in a long time, set up a visit today. Your Doctor, the key to your overall health care, knows your health history and helps make sure you get the care you need. Your Doctor can refer you to Specialists, if needed. This includes any gender health options that meet your medical needs, so share your treatment goals with your Doctor. You can change your IEHP Doctor at any time. Benefits Talk to your Doctor about these Gender Health Benefits: Behavioral Health Services Hormone Replacement Therapy Surgeries and Procedures IEHP has a dedicated team of Care Managers who are familiar with Gender Health services and are ready to help with: Referrals to see a specialist Getting medical supplies Getting medicines Connecting you to community resources IEHP also provides non-clinical resources such as: Care Coordination Community and Legal Resources Demographic updates Family Support Groups Resources For education and training on gender health care, please access the following resources: Gender Health Brochure for Adults (PDF) Gender Health Brochure for Children (For Parents and Children under 18) (PDF) Clinical Guidelines (PDF) LGBTQ Resources (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Download a free copy. Click Adobe Acrobat Reader.
How to Get Care
network is a group of Doctors, hospitals and other providers who work with IEHP. You must choose a PCP within 30 days from the time you become an IEHP Member. If you do not choose a PCP, IEHP will choose one for you. You may choose the same PCP or other PCPs for all family members in IEHP. If you have a Doctor you want to keep, or you want to find a new PCP, you can look in the IEHP Provider Directory. To help you choose the right one for you, PCPs listed in the IEHP network include their name, address, phone number, specialty, etc. If you change PCPs, you will get a new IEHP Member ID card in the mail. It will have the name of your new PCP. To change your PCP, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347.
How to Get Care - How to Get Care
l care, like: Routine checkups Sick visits, such as colds, flu and fever Chronic illnesses, like asthma and diabetes Order medical tests Your Doctor also handles your preventive care, such as vaccines, shots, health screenings and other tests. Preventive care is about preventing disease. Regular checkups, even when you are not sick, can help your Doctor spot a health problem early, and treat it before it gets worse. 2. Getting care from a Specialist When you need specialty care, your Doctor will refer you to a Specialist. This is how referrals work: When the request is received by IEHP, a decision will be made within 5 business days for a regular referral. For an urgent referral, this is done within 72 business hours. For a regular referral, expect a letter from your medical group or IEHP within 2 days after a decision has been made. When the request is approved, call your Specialist to make an appointment. If the request is denied, talk to your Doctor or call IEHP Member Services at (800) 440-4347 or (800) 718-4347 (TTY) to learn more. 3. Getting your medicine You can fill your prescription at any IEHP contracted pharmacy. There are more than 760 pharmacies in our network. From major chains, like Walgreens, CVS, Rite Aid, Walmart and many others. To find one close to you, check your IEHP Doctor Directory or click the Provider Search link. Helpful tips to help your treatment: Be sure to call the pharmacy five days before you run out of medicine. Take your medicine the way your Doctor tells you to. 4. Find a Doctor To find more information on Primary Care Physician's (PCPs), Specialists, Pharmacies, etc., click here to visit the Doctor search. 5. Getting help from Member Services If you need help, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. The call is toll free. If you reach IEHP Member Services after hours, you will be able to leave a secure voice message. Calls will be returned the next working day. If you call after midnight and leave a secure voice message, we will return your call the same working day. Resources Barriers to Care: We all have our own cultural, religious or health beliefs. This document includes some common beliefs that may keep you from getting the care you need—along with some facts to help you make informed decisions about your health.
COVID-19 - Mental Health
otions and how that balance (or imbalance) affects behavior and thoughts. What is stigma? There is still too much stigma surrounding behavioral and mental health. Historically, “crazy” or “mad” folks have been ostracized from society. This has been due to ignorance about mental health. Unfortunately, there is still too much fear and mis-understanding in our communities about mental health. Many people suffer from mental disorders. And given the current COVID-19 crisis, many more people will suffer from mental illness. Too many people suffer in silence with mental illness The statistics before COVID were about 1 in 5 people were diagnosed with a mental illness in America Those numbers will increase now during the COVID-19 crisis Mental Health includes wellness, self-care, emotional regulations, relationship issues, and parenting among other facets of everyday life Mental well-being is important to everyone Mental illness can happen to anyone Tips for staying mentally well during COVID-19 Self-care is critical: listen to your warning signs of struggling with your emotions and doing the basic things like showering, eating, sleeping, and exercise Do something that brings you enjoyment every day: play with your children or spouse, take walks, read a book, do something creative Connect with someone outside your home every day via telephone or other video technology Eat nutritiously, do not binge or eat too many sweets Avoid alcohol Continue to see your therapist via tele-health Continue to take care of your physical, financial, and spiritual needs Be patient with yourself and others Readily forgive yourself Exercise, do yoga, go for a walk. Stay active, but do not overdue it Remember that you are not alone. Many people are struggling or will struggle with mood and anxiety issues during this time . Reach out for help. Mental health help is available and we want you to seek help. Resources Psychiatry Walk-in Clinic (Montclair) Psychiatry Walk-in Clinic (Palm Desert) Teen Mental Health Guide A simple guide to manage stress
Community Resource Centers - FAQ
nters provide healthcare information, health education, fitness classes, and local resources to IEHP Members and the community. Our friendly bilingual staff are here to help you sign up for free classes, provide information on health benefits, learn about the health care system, and other local resources. We are conveniently located in Riverside, San Bernardino, and Victorville. Free services to everyone Walk-ins are welcome Interactive activities 2. What types of classes do you offer ? Fitness Classes: Stay active with Yoga, Zumba (all levels), Tai Chi, Line Dance, Yoga for Seniors & People with Disabilities, Meditation, Aerobic Box, Latin Dance, Strength and Conditioning and Kid fitness. Wellness Classes: Learn about topics like nutrition, healthy cooking, gardening, managing asthma symptoms, controlling diabetes, stress management, and classes for teens and kids too. Virtual classes: Enjoy fitness, learn about your health, and have fun with the whole family all from the comfort of your home. 3. What types of services do you offer? Assistance with benefits, Medi-Cal application process, health coverage, behavioral health services, local food pantries, job aid, transportation services, and much more. 4. How can I find resources online? IEHP Members and non-members can search for free or reduced cost services like medical care, food, job training, and more at www.connectie.org. 5. How can I connect to virtual classes? Click here to view the latest calendar. 6. If I’m not an IEHP Member, can I still join the classes? Yes! everyone is welcome. IEHP Members and non-members can participate in in-person or virtual classes. There are a few classes that are for IEHP Members only (see calendar for details). 7. Is there a fee to be part of the CRC or attend classes? All classes are absolutely FREE! 8. Do I need to register for a class and what are the requirements? There is no need to register. All classes are first come first serve, unless otherwise noted that pre-registration is required (see calendar for details). 9. How old do you have to be to participate in classes? Classes vary by age group. We offer children’s programs throughout the month (ages 0-5 and 4-11 with parents). In general, the fitness and health classes are for ages 12 and older, unless noted. Anyone under 18 years old (without a waiver signed by a parent/guardian*) must have an adult with them at all times. See the calendar for more details. *CRC Victorville location only 10. Do you have a daycare onsite? No. If you have any questions regarding children’s programming, please feel free to call and ask us at 1-866-228-4347. 11. Do I have to bring my own fitness equipment (yoga mats, etc.)? No. We offer classes that require little to no fitness equipment. 12. Is there a limit on how many classes I can take? There is no limit. 13. Can I be seen by a doctor at the CRC? No. However, our friendly and bilingual staff will assist you in finding a doctor if needed. Please call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. 14. Do you offer classes for seniors and people with disabilities? Yes. We offer classes including but not limited to, Meditation, Yoga for Seniors and people with Disabilities, and Low-Impact Zumba Gold.
Helpful Information and Resources - Texting Program FAQ
to view or change your doctor. If you have a smartphone, you can download the IEHP Smart Care App in either Google Play or the App Store. You call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. Watch this video to learn more. How do I find a Doctor, Urgent Care or Behavioral Health Provider? To find a list of providers in your area please visit https://search.iehp.org/. How do I make or change a doctor’s appointment? Please call your Doctor’s office to make/change an appointment. Your Doctor’s phone number is listed on your IEHP Member Card. How do I make an appointment with an eye doctor? For vision services, please call your Optometrist (Eye Doctor). Need to find an eye doctor? Click here https://search.iehp.org/ How do I print my IEHP Member Card or check my eligibility? You can login to the IEHP Member Portal to order (and print) your IEHP Member Card and check your eligibility. If you have a smartphone, you can download the IEHP Smart Care App in either Google Play or the App Store. You can also call IEHP Member Services at 1-800-440-IEHP (4347), 8am-5pm, Monday-Friday. TTY users should call 1-800-718-4347. Watch this video to learn more. How do I get more information on my Dental coverage? For dental coverage questions, please call Denti-Cal (dental program for Medi-Cal enrollees) at 1-800-322-6384 or visit https://dental.dhcs.ca.gov/ How do I change my address, phone or other contact information? You can login to the IEHP Member Portal to update your address or phone number. If you have a smartphone, you can download the IEHP Smart Care App in either either Google Play or the App Store. You can also call IEHP Member Services at 1-800-440-IEHP (4347), 8am-5pm, Monday-Friday. TTY users should call 1-800-718-4347. You should also contact your County Medi-Cal office to update your address or phone number. To report changes in Riverside County, call 1-877-410-8827 and in San Bernardino County, call 1-877-410-8829. Watch this video to learn more. How do I get information on enrollment in IEHP? You can contact our Enrollment Advisors at 1-866-294-4347 (or 1-800-720-4347 for TTY users), Monday-Friday, 8am-5pm. How can I cancel my benefits with IEHP? Call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. I am no longer an IEHP Member, how can I unsubscribe from the texting program? Reply STOP at any time or text back STOP to 90902. I am not a Member of IEHP, how can I cancel future messages? Reply STOP at any time or text back STOP to 90902. I am receiving text messages in Spanish and I only speak English. Can I change my language? To receive future messages in English, reply back “English” to any of our messages. I am receiving text messages in English and I only speak Spanish. Can I change my language? To receive messages in Spanish, reply back “Spanish” to any of our messages. Does IEHP offer transportation? For information about your transportation benefit, please refer to your Member handbook. Medi-Cal Member Handbook IEHP DualChoice Member Handbook How do I obtain status on my prescription? For information on your prescription, please call your pharmacy. If you have a question about your medicine, please talk to your Doctor. How do I find a nearby pharmacy? For DualChoice Members click here. For Medi-Cal Members click here.
Weight Management - Weight Management
ur health goals. Eat Healthy, Be Active Class A class for Members who want to learn how to eat healthy and be active. Members will learn about reading food labels, meal planning, and making healthier choices. Format: Group Duration: 4 weeks (2 hours per week) Ages: Any age (anyone under 18 years old must be accompanied by parent or guardian) Call IEHP Health Education Department at 1-866-224-IEHP (4347) or 1-800-718-4347 for TTY users to sign up. Diabetes Prevention Program (DPP) - Live the Life You Love Format: Online (small group) Duration: One year Ages: 18 years and over This online year-long lifestyle change program helps you make real changes that last. During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. In the second 6 months, you will meet monthly to practice what you have learned. No person is alike, so the program will be tailored to meet your needs and honor your customs and values. You will also be paired with a health coach for one year to help you set your goals, such as how to: Eat healthier Add physical activity into your daily life Reduce stress Improve problem-solving and coping skills Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Small changes can have big results! Let's start living the best version of you and living the life you love. Find out if you qualify! Click here to visit the Skinny Gene Project online, or Text “DPP” to 313131, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email email@example.com Click on the video below to learn more about this program.
Helpful Information and Resources - IEHP Voice ID
HP! In early 2022, IEHP launched an innovative technology called IEHP Voice ID. This voice recognition system uses your voiceprints to identify you. Your speech tones can be stored in safe databases and later used to identify your unique voice—like fingerprints or facial scans. How will I benefit from using IEHP Voice ID? By opting in to IEHP Voice ID, you can save the time it would take to go through the series of questions to prove your identity. Each Member who uses IEHP Voice ID could cut the time to verify their identity from 3 minutes to less than 30 seconds! Using IEHP Voice ID streamlines each call—our Member Services representatives will know right away that they are talking to the right member. Is it safe? IEHP Voice ID is more secure than passwords, PINS, security questions, and older forms of security. The IEHP Voice ID system will send an alert if it finds copied speech or a recorded voiceprint. Voice biometrics experts say that a voiceprint is safer. It includes more than 100 unique behavioral traits of each person, such as accent, pitch, length of the vocal tract, and so on. How can I sign up for IEHP Voice ID? IEHP Members can call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347 to sign up for IEHP Voice ID. The use of this service is optional. It does not cost you anything to sign up.
Helpful Information and Resources - Interpreter Service
t Doctor visit? IEHP offers language interpreter services to all IEHP Members - and it's free! We will send an interpreter to your Doctor's office, so you'll have someone there who knows your language. We schedule interpreters for most any language, including American Sign Language. To schedule a language interpreter, call IEHP Member Services at least 5 days before your Doctor visit. To cancel your request, call at least 2 days before your Doctor visit. Call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347.
Medi-Cal Rx Transition
he pharmacy benefit for IEHP Members. Prescription medications for IEHP Members will be covered by “Medi-Cal Rx”. Bring both your Medi-Cal ID Card and IEHP ID card to the pharmacy when you pick up your prescriptions to avoid delays. What is changing with my pharmacy benefit? Starting on January 1, 2022, you will get your Medi-Cal covered prescriptions through Medi-Cal Rx instead of IEHP. DHCS is working with a new contractor, Magellan Medicaid Administration, Inc. to provide pharmacy services. Will the cost of my medicines change? There will be no change in how you pay for your medicines. What do I need to do? Most people do not need to do anything. Your Doctors are being notified about the change. Will I need to change my medicines? Most people will not have to change their medicines. You will need to check the list of medicines covered by Magellan. The list of drugs that require prior approval may be different than the list IEHP uses. Your Doctor may need to get approval to refill prescriptions. He or she may talk to you about changing to a medicine that does not require prior approval. Will my pharmacy change? Most pharmacies will accept your new coverage. You can call the Medi-Cal Member Help Line (1-800-541-5555, TTY 1-800-430-7077) to ask if your pharmacy will accept Medi-Cal Rx. If your pharmacy does not work with Medi-Cal Rx, you may need to choose another pharmacy. What if I need help finding a pharmacy? The Medi-Cal Rx Pharmacy Locator online at www.Medi-CalRx.dhcs.ca.gov will be available in December 2021. Or starting on January 1, 2022, you can call Customer Service at 1-800-977-2273 24 hours a day, seven days a week or 711 for TTY Monday thru Friday, 8am to 5pm. What happens now? You will receive a new IEHP Member Card with the Magellan phone number. Always bring your IEHP Member Card and your Medi-Cal Benefits Identification Card (BIC) with you to your pharmacy. What if I have more questions? On or Before December 31, 2021 If you have questions about this notice or have Medi-Cal Rx general questions, contact the Medi-Cal Member Help Line (1- 800-541-5555, TTY 1-800-430- 7077), Monday thru Friday, 8am to 5pm. On or After January 1, 2022 You can call the Medi-Cal Rx Call Center Line (1-800-977-2273) 24 hours a day, seven days a week, or 711 for TTY, Monday thru Friday, 8am to 5pm. What happens if I have a complaint? Magellan will accept and resolve your complaint. You can submit a complaint either in writing or by telephone. You can only use this website and phone number to file a complaint on or after January 1, 2022. Visit www.Medi-CalRx.dhcs.ca.gov or call Customer Service at 1-800-977-2273. Can I still call IEHP for help with my pharmacy complaints? IEHP will no longer handle complaints for pharmacy services received on or after January 1, 2022. How does the change affect Members with Kaiser Permanente? Members with Kaiser Permanente can still get prescriptions through\ Kaiser-affiliated pharmacies.
MediCal Long-Term Services and Supports
le Members to help them live independently in the community. You may qualify for the LTSS services listed below. In-Home Supportive Services (IHSS) If you have a disability, are blind, or over 65 years old and not able to live in your home without help, you may qualify. Get help around the house and other daily care needs. With IHSS, you find your own caregivers to help with: Cooking meals and cleaning up Personal care services (such as bowel and bladder care, bathing, and grooming) Laundry and household cleaning, grocery shopping and errands, rides to Doctors visits To learn more about IHSS: San Bernardino County In-Home Supportive Services (877) 800-4544 (909) 252-4703 TTY, Monday-Friday, from 8am – 5pm Riverside County In-Home Supportive Services (888) 960-4477 (TTY 711), Monday - Friday, from 8am – 5pm Multipurpose Senior Services Program (MSSP) MSSP is a case management program that provides Home and Community-Based Services to Medi-Cal eligible individuals. To be eligible, you must be 65 years of age or older, live within a site’s service area, be able to be served with MSSP’s cost limitations, be appropriate for care management services, currently eligible for Medi-Cal, and certified or certifiable for placement in a nursing facility. Services include: Adult day care/support center Housing assistance Chore and personal care assistance Protective supervision Care management Respite Transportation Meal Services Social Services This benefit is covered up to $4,285 per year. To learn more about MSSP: San Bernardino County Multipurpose Senior Services Program (877) 565-2020, 24-Hour Hotline (909) 891-3900 TTY, Monday-Friday, from 8am – 5pm Riverside County Multipurpose Senior Services Program (800) 510-2020 (951) 867-3800 (951) 697-4699 TTY, Monday-Friday, 8am – 5pm Community Based Adult Services (CBAS) CBAS is an outpatient, facility-based service program where people attend based on a schedule. It offers skilled nursing care, social services, therapies (including occupational, physical, and speech), personal care, family/caregiver training and support, nutrition services, transportation, and other services. We will pay for CBAS if you meet the eligibility criteria. Learn about Community Based Adult Services (PDF) Nursing Facility (NF) A NF is a place that provides care for people who cannot get care at home but who do not need to be in a hospital. Nursing care Care management Bed and board (daily meals) X-ray and laboratory Physical, speech and occupational therapy Drugs given to you as part of your plan of care. To learn more about these programs, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm, TTY users should call 1-800-718-4347, and ask for the Long-Term Services and Supports (LTSS) Unit. Learn how IEHP helps Members transition back home (PDF) Here is placed a youtube LTSS Custodial Transitions Video Caregiver Resources in the Inland Empire By clicking on any of the links below, you will be leaving the IEHP website. Inland Caregiver Resource Center 1430 E Cooley Dr. Colton, CA 92324 (909) 514-1404 https://www.inlandcaregivers.com Services: Information and referral, family consultation, support groups, short-term counseling, educational workshops, respite and supplemental services. Alzheimer’s Greater Los Angeles 002 Iowa Ave, Suite 1072 Riverside, CA 92509 (909) 944-9146 https://www.alzgla.org Services: information and referral, 24/7 Hotline, Care Counselors, Early Stage Services, Memory Mornings, Support Groups, Community Education, and Advocacy. Senior Companions 600 West Fifth St. San Bernardino, CA 92410 (909) 384-5413 http://www.sbcity.org/cityhall/parks/senior_services/default.asp#SCP Senior Companions provide support to family caregivers. They assist with grocery shopping, transportation to medical appointments, meal preparation, encouraging clients to participate in daily activities, reminiscing, providing companionship and love. San Bernardino County Department of Aging and Adult Services 686 E. Mill St. San Bernardino, CA 92415 (909) 891-3900 http://hss.sbcounty.gov/daas/Default.aspx Services: Adult Protective Services, Family Caregiver Support, Long-Term Care Ombudsmen, Nutrition Services, Senior Employment Program, Information and Assistance Riverside County Office on Aging 6296 River Crest Dr., Suite K Riverside, CA 92507-0738 (951) 867-3800 https://www.rcaging.org Services: Care Coordination, Caregiving Resources, Care Transitions Intervention (CTI), Elder Abuse Education, Health Insurance Counseling and Advocacy Program (HICAP), Fit After 50, Grandparents Raising Grandchildren, Health Promotion, Legal Assistance, Nutrition, Senior Employment, Volunteer Services Community Access Center 6848 Magnolia Avenue, Suite 150 Riverside, CA, 92506 (951) 274-0358 http://www.ilcac.org/ Services: supportive services and independent living skills training. Rolling Start 1955 S. Hunt Street, Suite 101 San Bernardino, CA 92408 (909) 890-9516 http://www.rollingstart.com Services: disability information and referral, housing, independent living skills training, assistive technology, and advocacy. Alzheimer’s Association Ontario Office 3200 Inland Empire Blvd., Suite 280 Ontario, CA 91764 (909) 406-5376 https://alz.org/socal/about_us/our_regional_offices Palm Desert Office 74020 Alessandro Dr., Suite A Palm Desert, CA 92260 (760) 996-0006 https://alz.org/socal/about_us/our_regional_offices You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Download a free copy by clicking Adobe Acrobat Reader.
Medi-Cal Rights and Responsibilities
ghts: To be treated with respect, giving due consideration to your right to privacy and the need to maintain confidentiality of your medical records. To be given information about the plan and its services, including Covered Services, Practitioners, Providers, and Member rights and responsibilities. To be able to choose a PCP within IEHP’s network. To take part in decisions about your health care, including the right to refuse treatment. To voice grievances, verbally or in writing, about the organization or the care given. To provide feedback about the organization’s Member rights and responsibilities policies. To get care coordination. To request an appeal of decisions to deny, defer or limit services or benefits. To get oral interpretation services for their language. To get free legal help at your local legal aid office or other groups. To create advance directives. To have access to family planning services, Federally Qualified Health Centers, Indian Health Service Facilities, sexually transmitted disease services and Emergency Services outside IEHP’s network pursuant to federal law. To request a State Hearing, including instructions on how an expedited hearing is possible. To have access to, and where legal and appropriate, get copies of, amend or correct your Medical Record. To disenroll upon request. Members who can request expedited disenrollment include, but are not limited to, those getting services under the Foster Care or Adoption Assistance Programs and those with special health care needs. To access Minor Consent Services. To get written Member-informing materials in other formats (such as braille, large-size print and audio) upon request and in a timely fashion appropriate for the format being requested and in accordance with Welfare & Institutions Code Section 14182 (b)(12). To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation. To learn about and discuss available treatment options and alternatives with regard to cost or benefit coverage, presented in a manner appropriate to your condition and ability to understand. To get a copy of your medical records, and request amendments or corrections, as specified in 45 Code of Federal Regulations §164.524 and 164.526. To freely exercise these rights without adversely affecting how you are treated by IEHP, Providers or the State. To have access to family planning services, Freestanding Birth Centers, Federally Qualified Health Centers, Indian Health Service Facilities, midwifery services, Rural Health Centers, sexually transmitted disease services and Emergency Services outside IEHP’s network pursuant to the federal law. If you have been getting care from a health care provider, you may have a right to keep him or her for a certain time period. Please contact IEHP Member Services, and if you have more questions, please contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, 1-888-466-2219 (TTY) 1-877-688-9891, or online at https://www.dmhc.ca.gov/. As a Member of IEHP, you are responsible to: Be familiar with and ask questions about your health plan options, your health plan coverage limitations and exclusions, rules about the use of network providers, coverage and exclusions, rules, appropriate process to obtain information and process to appeal coverage decisions. If you have a question about your coverage, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. Follow the advice and care procedures requested by your Doctor and IEHP. If you have a question about these procedures, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. Request interpreter services at least 5 working days before a scheduled appointment. Call your Doctor or pharmacy at least 3 days before you run out of medicine. Cooperate with your Doctor and staff and treat them and other patients with respect. This includes being on time for your visits or calling your Doctor if you need to cancel or set up a new appointment. Understand that your Doctor’s office may have limited seating for patients and caregivers only. Give accurate data to IEHP, your Doctor, and any other provider. This helps you get better care. Understand your health care needs and be part of your health care decisions. Ask your Doctor questions if you do not understand. Work with your Doctor to make plans for your health care. Follow the plans and instructions for care that you have agreed on with your Doctor. Notify IEHP and your Doctor if you want to stop the plans and instructions you have agreed on or no longer want to participate in health management programs. Immunize your children by age 2 years and always keep your children’s vaccines up to date. Call your Doctor when you need routine or urgent health care. Care for your own health. Live an active life, exercise, have a good diet, and don’t smoke. Avoid knowingly spreading disease to others. Use IEHP’s grievance process to file a complaint. Call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347 to file a complaint (grievance or appeal). Report any fraud, waste or abuse to IEHP by calling the Compliance Hotline at (866) 355-9038 or the proper authorities. Understand that there are risks in getting health care and limits to what can be done for you medically. Understand that it is a health care provider’s duty to be efficient and fair in caring for you as well as other patients.
Medi-Cal Preventive Care Services
o can get preventive care services? IEHP Members who are infants, children, and youth up to age 21 can get these services at no cost. What are preventive care services? Services that ensure that infants, children, and youth under age 21 get the care they need at the right age. This includes screenings for medical, dental, vision, hearing, mental health, and substance use disorders. You or your child may also get developmental services, specialty care, and needed vaccines to keep you healthy. Developmental services include early intervention through screening tools such as the Ages and Stages Questionnaire (ASQ-3). The ASQ-3 is a developmental screening for children ages 0-5 that provides a fast, helpful, and detailed look at how your child is growing and developing. IEHP provides a free online ASQ-3 screening for your child at any time. Click here to request a free ASQ-3 screening. IEHP covers screenings (including lead blood-level assessment) any time you need them at no cost to you. Check-ups and screenings can help Doctors find health issues early. If a physical or behavioral health issue is found during a check-up or screening, IEHP will cover the care needed to address it. How do I get preventive care services? Set up a visit for any check-ups, screenings or other preventive care through your or your child’s Doctor. If you or your child are eligible to receive the COVID-19 vaccine (5 years or older), it is also important that you get the vaccine as soon as possible. To set up an appointment, please visit https://myturn.ca.gov/. To learn more about preventive care services, please call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. Immunization schedule 2022 (PDF)
ur top priority. We’ll continue to update this web page with the latest information and instruction regarding Coronavirus (COVID-19). Announcements 5/02/22: The FDA extended the expiration dates for a number of antigen over-the-counter COVID-19 test kits. Watch this video to learn more. 2/15/21: Effective February 16, 2022, the state of California will no longer require vaccinated people to wear masks indoors in public places. Unvaccinated people are still required to wear masks indoors. Masking indoors will only be “strongly recommended” by the State for those who are vaccinated. Click here to learn more. 2/4/21: On January 31, 2022, the Food and Drug Administration (FDA) approved the second COVID-19 vaccine - Moderna’s Spikevax vaccine (widely known as the Moderna vaccine). The Spikevax vaccine, is now approved for use in people ages 18 and older. Click here to learn more. 1/19/21: Every home in the U.S. is eligible to order one free COVID-19 test kit, which includes four at-home tests. The tests are completely free. Click here to order your free at-home tests. 1/07/21: The recent rise of the Omicron variant further stresses the importance of COVID vaccines, boosters, and preventive efforts (use of masks) are needed to protect against COVID-19. Schedule your vaccine today: www.myturn.ca.gov 1/06/21: The Centers for Disease Control and Prevention expands booster shot eligibility for 12–17-year-olds. Click here to learn more. 10/29/21: The Food and Drug Administration authorizes Pfizer-BioNTech COVID-19 vaccine for emergency use in children 5 through 11 years of age. Click the link to make an appointment. https://myturn.ca.gov/ 9/23/21: The Food and Drug Administration (FDA) authorizes a booster shot of Pfizer BioNTech COVID vaccine for the following populations: people 65 years of age or older, people 18-64 years of age at high risk of severe COVID-19, and people 18-64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19. Click here to learn more. 8/17/21: The FDA amended the emergency use of Pfizer and Moderna COVID-19 vaccine to allow an additional dose to be given to people with moderately to severely compromised immune systems after the initial 2-dose series. Click here to learn more. 8/17/21: The CDC recommends the COVID-19 vaccine for people who are pregnant, breastfeeding, trying to get pregnant or may become pregnant in the future. Unvaccinated women who are pregnant or were recently pregnant are more likely to get severely ill with COVID-19 compared with non-pregnant women. Click here to learn more. 8/06/21: Nearly all COVID deaths in the US are now among the unvaccinated. Protect yourself from the new surge in our region. Get vaccinated. Click here to make an appointment. 5/20/21: On June 15th, fully vaccinated Californians can go mask-free in most indoor settings. Click here for more information. 5/20/21: San Bernardino County urges residents to get vaccinated for COVID-19. Walk-ups are now allowed at all County-operated sites and many private-run sites. Getting protected could not be easier. Click here for more information. 5/13/21: The Pfizer COVID-19 vaccine is now available for children ages 12-15. Click here to make an appointment. 4/26/21: Riverside County reinstates the use of the Johnson and Johnson vaccine. Click here to learn more. 4/16/21: Riverside and San Bernardino County temporarily pause the use of the Johnson & Johnson COVID-19 vaccine in accordance with recommendations made by state and federal health agencies. Click here to learn more. 4/7/21: San Bernardino County residents ages 16+ are now eligible to get the COVID-19 vaccine. Click here to make an appointment. 4/6/21: Riverside County residents ages 16+ are now eligible to get the COVID-19 vaccine. Click here to make an appointment. 4/1/21: Omnitrans is offering San Bernardino county residents two FREE shuttle services to those with COVID-19 vaccine appointments in Ontario and San Bernardino. Click here for more information. 3/29/21: Starting April 1st, Riverside and San Bernardino County residents 50+ can get the COVID-19 vaccine and on April 15th all residents 16+ can get the vaccine. To make appointment, click on your county below. Riverside county San Bernardino county 3/29/21: San Bernardino County residents who accompany an eligible family member to an appointment are now eligible to receive the COVID-19 vaccine, even if they don’t fall into an eligible category. Residents must have an appointment at the same location and at approximately the same time as their eligible family member. Click here to make an appointment. 3/19/21: San Bernardino County residents that are high risk or disabled do not need to show proof of eligibility to get the COVID-19 vaccine. Residents will only be asked to self-attest to their eligibility. Click here to learn more. 3/12/21: Starting next week, San Bernardino County residents ages 16-64 with underlying medical conditions and/or a disability will be eligible for the COVID-19 vaccine. Click here to learn more. 3/10/21: The Centers for Disease Control and Prevention (CDC) has issued new guidance that allows people who are fully vaccinated to gather with each other without wearing masks. Click here to learn more. 3/03/21: San Bernardino County opens COVID vaccine appointments for food and agriculture workers. Click here to learn more. 2/26/21: To support COVID-19 vaccination efforts, IEHP partnered with San Bernardino County to open a new vaccine site at our headquarters in Rancho Cucamonga. Appointments are required and can be made at SBCovid19.com/vaccine. 2/17/21: San Bernardino County announces additional vaccine sites for seniors 65+ interested in getting the COVID-19 vaccine. Click here for more information. 2/10/21: San Bernardino County residents 65+ are urged to sign up to be notified when new COVID-19 vaccine appointments become available. Click here to sign up. 2/1/21: Riverside County residents who received their first dose of the COVID-19 vaccine at a county clinic will be contacted by the county health officials to schedule their second dose. Click here to learn more. 1/29/21: Riverside County has appointments available for residents 85+ who are interested in getting the COVID-19 vaccine. Click here to view available appointments. 1/25/21: California has lifted the regional stay-at-home orders issued in December, moving San Bernardino and Riverside County back into the purple tier. Residents are urged to continue safe practices, avoiding crowds, and wearing a mask when leaving home. In addition, increased testing will help the counties move into the next level of the state’s reopening plan. 1/22/21: Riverside County will open appointments Saturday, January 23rd for the upcoming COVID-19 vaccine clinics. Click here to register. 1/15/21: San Bernardino County residents ages 65 and over are now eligible for the COVID-19 vaccine. Click here for vaccine locations and registration. 1/14/21: Riverside county residents 65 and over can now get vaccinated for COVID-19 at various locations throughout the county. Click here for more information. Click here to view additional announcements Local Resources San Bernardino County 2-1-1 San Bernardino County Wic Riverside County Wic
Resources for the Uninsured
y for healthcare coverage through Medi-Cal, Covered California, or for county-based programs. Apply for health coverage through Medi-Cal and choose IEHP, your Inland Empire Health Plan. Get quality medical, behavioral health and wellness services and no cost. What is Medi-Cal? Medi-Cal is a no-cost or low-cost health coverage program. It provides health, dental and vision coverage to qualified low-income California residents. How do I apply for Medi-Cal: Apply for no-cost health coverage right over the phone. Call the IEHP Enrollment Advisors at (866) 294-4347, Monday – Friday, 8am – 5pm. TTY users should call (800) 720-4347. You may also call Health Care Options at 1-800-430-4263 or visit or visit www.healthcareoptions.dhcs.ca.gov. TTY users should call 1-800-430-7077. Click here to learn more. What is Covered California? Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It’s the only place where you can get financial help when you buy health insurance from well-known companies. Click here to learn more.https://www.coveredca.com/ County Health Clinics If you are uninsured and do not qualify for IEHP you can find free/low cost health clinics and prescription drug assistance programs in Riverside and San Bernardino counties with our Healthcare Connections PDFs: San Bernardino (PDF) Riverside (PDF) How can I find resources in my community? IEHP Community Resource Centers The IEHP Community Resource Centers (CRC) are your local resource for healthcare information in Riverside, San Bernardino and Victorville. Our bilingual staff can help you to take free classes, learn about health care & learn about health coverage. Click here to learn more. Connect IE Connect IE is a new one-stop, interactive website that makes it easy to link people to community resources in the Inland Empire. By clicking on the link below you will be leaving the IEHP site. Visit ConnectIE to find out more! Resources for the undocumented Public Charge Information The ABC's of Public Charge You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Download Adobe Acrobat Reader.
Super Heroes - Mighty Fitnessa
ity for a healthy body and healthy mind. The campaign features appearances by Mighty Fitnessa at numerous IEHP supported community events. Children, young adults and families can meet her in person at these events and receive free comic books, posters, brochures and other fitness related education materials. Mighty Fitnessa Video Mighty Fitnessa Comic Book (PDF)
Join Our Network - PCP & Specialists
HP) directly contracted provider. Prior to extending a contract, we must receive the following documents. Please completely fill out all required documents. Any delay in receiving the below stated documents will affect the effective date of the contract that will be mailed to you. New Contract Existing Contract (Adding New Provider) Physician Network Form (PDF) Medical-Number (Physicians and Medical Groups should be enrolled in the State's Medi-Cal Program) Physicians and Specialists (PDF) (M.D., D.O., D.P.M., D.C., O.D., S.P., AuD., P.T., etc) Pre-Contractual Letter (PDF) (Only applies to PCPs. Please review and return signed if all outlined criteria is met) Mid Level Practitioners (PDF) (P.A., N.P., and C.N.M.) Supervisor Agreement (PDF) (Only Applies to Physician Assistants) Medical-Number (Physicians and Medical Groups should be enrolled in the State's Medi-Cal Program) All documents should be e-mailed to firstname.lastname@example.org. All documents should be e-mailed to email@example.com. Provider Maintenance Request Form (PCP, OB/GYN, and Mid-Levels ONLY) can be found here (PDF). Contracts Maintenance Request Form (Specialists ONLY) can be found here (PDF). Individual W-9 form can be found here (PDF). Direct Deposit Frequently Asked Questions can be found here (PDF). National Plan & Provider Enumeration System (NPPES) Portal login: https://nppes.cms.hhs.gov/#/. NPI Address Update Instructions can be found here (PDF). You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - Vision
contracted provider. Prior to extending a contract, we must receive the following documents. PLEASE NOTE, IEHP is only accepting Vision Providers who meet the following exceptions through October 31, 2022: Providers practicing in any of the CalAIM service area expansion territories effective January 1, 2022 (including formerly voluntary and excluded zip codes) Providers filling positions that have been vacated in an existing practice Providers transitioning from an existing group agreement to their own individual agreement Providers being added to existing Vision groups Please completely fill out all required documents and submit to firstname.lastname@example.org. Any delay in receiving the below stated documents will affect the effective date of the contract that will be mailed to you. 1. Vision Provider Network Participation Form (PDF) 2. Letter of Interest that outlines the following: What Specialty/Services you are interested in contracting for Facility locations(s) National Provider Identifier (NPI) for each facility Medi-Cal Provider information number (PIN) 3. W-9 Form (PDF) A current Taxpayer Identification Number and Certification Form 4. California Participating Physician Application (PDF) 5. Liability Insurance Certificate Professional general liability in the minimum amount of One Million Dollars ($1,000,000) per occurrance; and Three Million Dollars ($3,000,000) aggregate per year for professional liability 6. Facility Business License - Faculty 7. Ownership Information (PDF) Name, Title, and Percent of Ownership Contracts Maintenance Request Form can be found here (PDF). All documents should be e-mailed to email@example.com. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
IEHP DualChoice - D-SNP Transition
IEHP DualChoice (HMO D-SNP) on January 1, 2023. Unless you change plans, IEHP DualChoice (HMO D-SNP) will provide your Medicare benefits. You will keep all of your Medicare and Medi-Cal benefits. You will not have a gap in your coverage. You will be automatically enrolled in IEHP DualChoice and do not need to do anything to keep these services. IEHP DualChoice is very similar to your current Cal MediConnect plan. With IEHP DualChoice, you will still have an IEHP DualChoice Member Service team to get help for your needs. You won’t pay a premium, or pay for doctor visits or other medical care if you go to a provider that works with our health plan. To learn more about your prescription drug costs, call IEHP DualChoice Member Services. To ask if your PCP or other providers are in our network in 2023, call IEHP DualChoice Member Services. Click here to learn more about IEHP DualChoice. What services will my Medicare Medi-Cal Plan cover? IEHP DualChoice will cover many of the Medicare and Medi-Cal benefits you get now, including: All Medicare covered services, doctors, hospitals, labs, and x-rays You will have access to a Provider network that includes many of the same Providers as your current plan Prescription drugs covered by Medicare Coordination of the services you get now or that you might need Transportation to medical services Medical supplies Durable Medical Equipment (DME) Nursing home care Community-Based Adult Services (CBAS) You will have access to a Provider network that includes many of the same Providers as your current plan. You will not have a gap in your coverage. You will be automatically enrolled in a Medicare Medi-Cal Plan offered by IEHP DualChoice. You don’t have to do anything if you want to join this plan. If you want to change plans, call IEHP DualChoice Member Services. If you have questions, you can contact IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY: 1-800-718-4347.
IEHP DualChoice - Making Complaints
he kinds of problems related to: Quality of your medical care Respecting your privacy Disrespect, poor customer service, or other negative behaviors Physical accessibility Waiting times Cleanliness Information you get from our plan Language access Communication from us Timeliness of our actions related to coverage decisions or appeals How to file a Grievance with IEHP DualChoice (HMO D-SNP) 1. Contact us promptly – call IEHP DualChoice at (877) 273-IEHP (4347), 8am - 8pm, 7 days a week, including holidays.TTY users should call 1-800-718-4347. You can make the complaint at any time unless it is about a Part D drug. If the complaint is about a Part D drug, you must file it within 60 calendar days after you had the problem you want to complain about. If you do not wish to call (or you called and were not satisfied), you can put your complaint in writing and send it to us. If you put your complaint in writing, we will respond to your complaint in writing. You can use our "Member Appeal and Grievance Form." All of our Doctor’s offices and service providers have the form or we can mail one to you. You can file a grievance online. You can give a completed form to our Plan provider or send it to us at the address listed below or fax the completed form to the fax number listed below. This form is for IEHP DualChoice as well as other IEHP programs. IEHP DualChoice P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Fax: (909) 890-5877 Whether you call or write, you should contact IEHP DualChoice Member Services right away. 2. We will look into your complaint and give you our answer If possible, we will answer you right away. If you call us with a complaint, we may be able to give you an answer on the same phone call. If your health condition requires us to answer quickly, we will do that. Most complaints are answered in 30 calendar days. If we need more information and the delay is in your best interest or if you ask for more time, we can take up to 14 more days (44 days total) to answer your complaint. If we do not agree with some or all of your complaint or don’t take responsibility for the problem you are complaining about, we will let you know. Our response will include our reasons for this answer. We must respond whether we agree with the complaint or not. Fast Grievances If you are making a complaint because we denied your request for a “fast coverage determination” or fast appeal, we will automatically give you a “fast” complaint. If you have a “fast” complaint, it means we will give you an answer within 24 hours. Who may file a grievance? You or someone you name may file a grievance. The person you name would be your “representative.” You may name a relative, friend, lawyer, advocate, doctor, or anyone else to act for you. Other persons may already be authorized by the Court or in accordance with State law to act for you. If you want someone to act for you who is not already authorized by the Court or under State law, then you and that person must sign and date a statement that gives the person legal permission to be your representative. To learn how to name your representative, you may call IEHP DualChoice Member Services. External Complaints You can tell Medicare about your complaint You can send your complaint to Medicare. The Medicare Complaint Form is available at: https://www.medicare.gov/MedicareComplaintForm/home.aspx. Medicare takes your complaints seriously and will use this information to help improve the quality of the Medicare program. If you have any other feedback or concerns, or if you feel the plan is not addressing your problem, please call (800) MEDICARE (800) 633-4227). TTY/TDD (877) 486-2048. The call is free. You can tell Medi-Cal about your complaint The Office of the Ombudsman also helps solve problems from a neutral standpoint to make sure that our members get all the covered services that we must provide. The Office of the Ombudsman is not connected with us or with any insurance company or health plan. The phone number for the Office of the Ombudsman is 1-888-452-8609. The services are free. You can tell the California Department of Managed Health Care about your complaint The California Department of Managed Health Care (DMHC) is responsible for regulating health plans. You can call the DMHC Help Center for help with complaints about Medi-Cal services. You may contact the DMHC if you need help with a complaint involving an urgent issue or one that involves an immediate and serious threat to your health, you disagree with our plan’s decision about your complaint, or our plan has not resolved your complaint after 30 calendar days. Here are two ways to get help from the Help Center: Call (888) 466-2219, TTY (877) 688-9891. The call is free. Visit the Department of Managed Health Care's website: http://www.dmhc.ca.gov/ You can file a complaint with the Office for Civil Rights You can make a complaint to the Department of Health and Human Services’ Office for Civil Rights if you think you have not been treated fairly. For example, you can make a complaint about disability access or language assistance. The phone number for the Office for Civil Rights is (800) 368-1019. TTY users should call (800) 537-7697. You can also visit https://www.hhs.gov/ocr/index.html for more information. You may also contact the local Office for Civil Rights office at: U.S. Department of Health and Human Services 90 7th Street, Suite 4-100 San Francisco, CA 94103 Telephone: (800) 368-1019 TDD: (800) 537-7697 Fax: (415) 437-8329 You may also have rights under the Americans with Disability Act. You can contact the Office of the Ombudsman for assistance. The phone number is (888) 452-8609. When your complaint is about quality of care You have two extra options: You can make your complaint to the Quality Improvement Organization. If you prefer, you can make your complaint about the quality of care you received directly to this organization (without making the complaint to our plan). To find the name, address, and phone number of the Quality Improvement Organization in your state, look in Chapter 2 of your IEHP DualChoice Member Handbook. If you make a complaint to this organization, we will work with them to resolve your complaint. Or you can make your complaint to both at the same time. If you wish, you can make your complaint about quality of care to our plan and also to the Quality Improvement Organization. For more information on Grievances see Chapter 9 of your IEHP DualChoice Member Handbook. Handling problems about your Medi-Cal benefits If you have Medi-Cal with IEHP and would like information on how to pursue appeals and grievances related to Medi-Cal covered services, please call IEHP DualChoice Member Services at (877) 273-IEHP (4347), TTY (800) 718-4347, 8am - 8pm (PST), 7 days a week, including holidays. IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) depends on contract renewal. Information on this page is current as of October 01, 2022. H8894_DSNP_23_3241532_M