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Do I qualify for Gold Coast Health Plan Total Care Advantage (HMO D-SNP)?

Gold Coast Health Plan Total Care Advantage (HMO D-SNP) provides Medicare and Medi-Cal services to individuals who are eligible for both programs.

You’re eligible for our plan if you:

  • Live in our Ventura County, and
  • Are age 21 and older at the time of enrollment, and
  • Have both Medicare Parts A and B, and
  • Currently have full Medi-Cal (no share of cost).

Here is how it works. Our plan is approved by Medicare and Medi-Cal to provide you with your benefits.

Medicare

Medicare is the federal health insurance program for:

  • People 65 years of age or over,
  • Some people under age 65 with certain disabilities, and
  • People with end-stage renal disease (kidney failure).

Medi-Cal

Medi-Cal is the name of California’s Medicaid program. Medi-Cal is run by the state and is paid for by the state and the federal government. Medi-Cal helps people with limited incomes and resources pay for Long-Term Services and Supports (LTSS) and medical costs. It covers extra services and drugs not covered by Medicare.

You can get Medicare and Medi-Cal services through our plan as long as:

  • You are eligible, and
  • You choose to be in our plan, and
  • The plan is offered and approved by Medi-Cal and Medicare.

What if I lose my Medi-Cal?

Some people lose their Medi-Cal eligibility. Once you join that plan, if you lose Medi-Cal eligibility but can be expected to get it back regain it within four (4) months, then you can stay on the plan. If you lose your Medi-Cal for more than 4 months, you will not be eligible for our plan.

If you have any questions or need help, please call our Member Services Team at 1.888.301.1228, 8 a.m. to 8 p.m., seven days a week from Oct. 1 through March 31, and 8 a.m. to 8 p.m. Monday through Friday from April 1 through Sept. 30. If you use a TTY, call 711. You can also visit our website at www.goldcoasthealthplan.org. We are here to help you!