To learn more about the HHP:
- Call your Medi-Cal health plan. To find the phone number, check your Medi-Cal ID card or go to http://bit.ly/plandirectory
- Call Health Care4 Options at 1-800-460-4263 (TTY 1-800-430-7077).
- Ask your doctor or clinic about the program.
The Health Homes Program
What is Health Homes?
Health Homes is a new program for eligible Medi-Cal members with complex medical needs and chronic conditions who may benefit from enhanced care management and coordination.
Health Homes Program (HHP) offers a care team who can work with your health care providers, specialists, pharmacies, case managers, caregivers, and others, in order to coordinate your care. You are assigned a care manager who also acts as your advocate when you experience challenges obtaining needed services, making appointments, obtaining medical equipment, referrals, and much more. This combination of coordination and advocacy can help ensure that your providers are all staying informed on your care, and that all are working toward the same goal(s). By providing you with your own advocate, we strive to ensure that your voice is not lost, and that your needs are being met appropriately. If you have additional needs that impact your stability, your care team can also help in identifying resources within the community that might be of assistance. This wraparound approach aims to support your health, overall well-being, and self-care.
The HHP coordinates the full range of physical health, behavioral health, and community-based long-term services and supports (LTSS) needed by eligible Medi-Cal beneficiaries with complex medical needs and chronic conditions who may benefit from enhanced care management.
The HHP provides six core services:
- Comprehensive care management.
- Care coordination (physical health, behavioral health, community-based LTSS).
- Health promotion.
- Comprehensive transitional care.
- Individual and family support.
- Referrals to community and social support services, including housing.
I already have insurance. Will this change my medical plan and doctors?
No, none of the care that you currently receive will change. Health Homes is not a medical plan, but rather, it is a benefit available to you on behalf of your current medical coverage. Your doctors and other services will remain the same. Health Homes simply offers you a care manager and care team to assist you in collaborating and advocating with your doctors and other providers. The Medi-Cal services you get now will not change or be taken away. You can still see your same doctors, but now you can get extra help.
Do I qualify?
You may qualify if you meet the Health Homes criteria for serious/chronic medical/mental health conditions, if you stayed in the hospital in the past year, and/or visited the emergency room three or more times in the past year. You can call your plan directly to find out if you qualify. You must be enrolled in a Medi-Cal health plan to access HHP services. If you need help enrolling into a Medi-Cal plan, you can call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077).
You do not qualify if you receive hospice services or if you have been residing in a skilled nursing facility for longer than one month.
How much does this service cost?
There is no cost to you. This service is provided to you at no out-of-pocket cost because it is a benefit offered by your medical insurance.
I have too many appointments already. What if I’m just too busy?
Health Homes does not require a significant time commitment from you. Your care manager will ask for a meeting (in person or phone call.) If you have many needs and would like to meet with your care manager more frequently, additional contacts may be scheduled. In-person visits may take place in the primary care setting, in hospitals, or emergency departments, in the community or in your home. Aside from that, your care manager will be checking in with you via monthly phone calls. In fact, Health Homes can often prove helpful in reducing your overwhelming obligations by taking on some of those urgent tasks so that you may feel less burdened. We are here to help.
I’m always getting calls from people claiming they are calling on behalf of my insurance. How do I know this is not a scam?
If you received a call from a care team member to offer information regarding the Health Homes program, you have already been referred by your medical plan. You may call your plan directly to inquire about Health Homes services and the reason why you were referred.
Exodus Recovery, Inc. is currently partnering with Blue Shield Promise.
I’m interested. What do I do to sign up?
When a Health Homes care manager contacts you, inform him/her that you are interested in enrolling. The care manager will schedule a time to meet (at a location most convenient to you) in order to complete your intake and enroll you into the program.
I have questions. How do I contact you?
You may contact HHP by calling 760-305-4860.
Monica Oropeza, MSW – Care Manager
Lorena (Lori) Hilden, BS – Care Manager
Joanna Quezada, LVN – Lead Clinical Coordinator
Rosa Lopez – Referral Coordinator
We are located at:
550 West Vista Way, Suite 204
Vista, CA 92083