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  • Please note that our recently extended call center hours of 7 a.m. to 6 p.m. will be changing. Starting Sept. 27, 2021, our call center business hours will be changing back to our normal business hours of Monday through Friday from 8 a.m. to 5 p.m. If you have any questions, please feel free to call 1.888.301.1228.
  • Providers: Starting Sept. 1, 2021, we will be reverting to the Clinicas Del Camino Real and Gold Coast Health Plan Division of Financial Responsibility (DOFR) that was in place prior to May 1, 2020. Click here to learn more.

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Long-Term Care

Gold Coast Health Plan (GCHP) covers long-term care services in licensed nursing facilities. Nursing facilities provide:

  • Room and board.
  • Skilled nursing care 24 hours a day.

If you can't perform daily activities on your own, these services will help you live as safely as possible.

How to Access Long-Term Care

GCHP will cover your long-term care services for you and covered family members. You only need to have prior authorization from your Primary Care Provider (PCP).

Long-term care services are available to help with your health and personal care needs. They can help for a short or extended time. You might need a short stay while recovering from surgery. Or you may have a chronic condition that can't be taken care of at home.

For whatever reason, your stay will be covered as long as you get a prior OK from your PCP.

Types of Long-Term Care Facilities

Your GCHP provides coverage for stays in:

  • Long-term care facilities.
  • Skilled nursing facilities.
  • Intermediate care facilities.
  • Intermediate care facilities for the developmentally disabled. This includes developmentally disabled habilitative care or developmentally disabled nursing.
  • Sub-acute care facilities.
  • Congregate health living facilities.

Call Us to Learn More

You're covered for long-term care as long as you're a member of GCHP and your doctor has approved this type of service for you. To learn more, call Member Services at 1.888.301.1228. If you use a TTY, call 1.888.310.7347.