Standard U.S. Postage PAID Long Beach, CA Permit No. 2041 WINNING Compassionate care, accessible to all, for a healthy community. ISSUE 1, SUMMER 2022 Care Management If you want to learn more about your benefits or local resources, Gold Coast Health Plan’s (GCHP) Care Management team can help. They can help you coordinate your health care and learn about: ❱ Your benefits. ❱ Your condition. ❱ Community programs. The Care Management team is made up of nurses, social workers and coordinators. They all work together to empower members to improve their health. To learn more, call: ❱ Care Management member hotline: 1-805-437-5656 (Monday through Friday, 8 a.m. to 5 p.m.) ❱ GCHP Member Services: 1-888-301-1228 (Monday through Friday, 8 a.m. to 5 p.m.) ❱If you use a TTY, call: 1-888-310-7347 Welcome, new members! If you are new to Gold Coast Health Plan (GCHP), welcome! We are here to support you. As a new member, you should have received a welcome packet from GCHP with a Provider Directory and a form to choose a Primary Care Provider (PCP). Once you choose a PCP, you will receive a GCHP ID card and a Member Handbook. If you need help choosing a PCP, GCHP’s Member Services team can help you. The team can also help you: ●Understand your benefits. ●Get in touch with a care manager. ●Connect to mental health services through our partner, Beacon Health Options. ●Reach out to the Health Education Department for resources and language assistance services. ●File a complaint or grievance. You can call Member Services at 1-888-301-1228 Monday through Friday from 8 a.m. to 5 p.m. If you use a TTY, call 1-888-310-7347. We look forward to partnering with you on your journey to good health. Medi-Cal expansion As of May 1, 2022, those who are 50 years of age and older may qualify for full-scope Medi-Cal benefits despite their immigration status. They must meet all Medi-Cal eligibility criteria. Contact the local Medi-Cal County office for more information or to apply. DO YOU HAVE A NEW ADDRESS? Update it now by calling: Human Ser vices Agency (HSA): 1-888-472-4463 TTY: 1-800-735-2929 (Monday through Friday from 8 a.m. to 5 p.m.)
24-Hour Advice Nurse Line: 1-877-431-1700/TTY 711 2022 © Coffey Communications, Inc. All rights reserved. Member Services Luis Aguilar Health Education Lupe González, PhD, MPH Editor-in-Chief Susana Enriquez-Euyoque Chief Medical Officer Nancy R. Wharfield, MD Copy Editor Calley Griffith WINNING HEALTH is published as a community service for the friends and patrons of GOLD COAST HEALTH PLAN, 711 E. Daily Drive, Suite #106, Camarillo, CA 93010-6082, telephone 1-888-301-1228/TTY 1-888-310-7347. Information in WINNING HEALTH comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Models may be used in photos and illustrations. WINNING If you are a Kaiser or AmericasHealth Plan member, this information may not apply to you. 2 Stay active for your good health There’s good reason to make a point of staying active. For one thing, exercise helps your immune system stay healthy. It’s also a great way to cope with the stress and anxiety you may be feeling. THINK OUTSIDE THE GYM ❱ Take a walk or go for a bike ride. ❱ Dance to your favorite music or invite friends to a vir tual dance par ty. ❱ If you have stairs, climb up and down for 10 minutes at a time. ❱ Work on a strengthening routine with moves like push-ups. ❱ Make up your own jump rope game and invite your friends or family to play. ❱ Stream a free yoga video. ❱ Get out and plant vegetables in your garden or a local community garden. ❱ Play active games, like soccer, with your family. ❱ Make up a circuit workout with different activities in each room, like jumping jacks, burpees, and lunges. Sources: American Council on Exercise; American Heart Association Postpartum care: Mom’s health matters too New moms go through many changes after having a baby. With so much going on, it may be hard to remember to take care of yourself, but doing so will help you and your new baby! The Postpartum Care Extension Program is available to Gold Coast Health Plan (GCHP) members. It provides health care coverage during and after pregnancy for up to 12 months after the end of the pregnancy, regardless of income, citizenship, or immigration status. Giving birth affects your body ●Changes in your uterus (womb): • It will take some time for your uterus to go down to the size it was before you were pregnant. • Your vaginal discharge will be heavy and bright red for the first few days after delivery. • You may still have vaginal discharge that is brown or has a small amount of blood for three to six weeks. ●Changes in your breasts: • Your breasts will grow to be able to feed your baby if you choose to breast feed. • They may feel full, tender, and uncomfortable. • Milk may leak from your nipples. ●Talk to your doctor about any postpartum concerns, such as: • Depression. • Hard stools (constipation). • Hemorrhoids. Remember: Schedule a visit with your doctor for a postpartum visit no more than three months after delivery. Postpartum depression Your body and mind go through many changes during and after pregnancy. Ask for help if you feel empty, emotionless, or sad all or most of the time for longer than two weeks during or after pregnancy. Talk to your doctor if you feel like you don’t love or care for your baby. GCHP members can call 1-855-765-9702 Monday through Friday, 8 a.m. to 8 p.m. or visit www.goldcoasthealthplan.org for information about depression or other mental health resources. If you use a TTY, call 1-800-735-2929.
3 Member Services: 1-888-301-1228/TTY 1-888-310-7347 Breast and cervical cancer screenings Early detection can lead to lifesaving treatments. Routinely screening for breast and cervical cancer is the best way to reduce your risk of serious complications or dying of these diseases. Talk to your doctor about completing one or more of these screenings. When you should get screened ●Cervical cancer screening (Pap): between 21 and 64 years of age. ●Breast cancer screening (mammogram): between 50 and 74 years of age or sooner if your doctor feels you are at risk. Questions you may want to ask your doctor ●What are my risks of getting breast or cervical cancer? ●How often should I be tested? ●What will happen during the test? ●When and how will I learn about the results? ●When will I need to have my next screening? GCHP members can be seen by a female doctor If you would like to be seen by a female doctor, talk to your doctor’s office. They can schedule your appointments with a female doctor. You can also search the Gold Coast Health Plan (GCHP) Provider Directory for a female doctor. Select or change your doctor by calling Member Services at 1-888-301-1228 Monday through Friday, from 8 a.m. to 5 p.m. If you use a TTY, call 1-888-310-7347. Members can ask for an interpreter and request a female interpreter during their doctor’s visit. To schedule an interpreter, call Member Services. You can find a list of imaging centers where you can schedule your free mammogram on www.goldcoasthealthplan.org. Go to “Health Resources,” then “Health Education” and “Breast Cancer Resources.” Did you know…? You can ask your Primary Care Provider (PCP) for a referral to a specialist. You and your PCP will work together to choose a specialist. For more information, contact Member Services at 1-888-301-1228, Monday through Thursday from 8 a.m. to 5 p.m. If you use a TTY, call 1-888-310-7347. Get rewarded for taking care of your health! Gold Coast Health Plan (GCHP) members can get a gift card to Target, Walmart, or Amazon for completing health care exams by Dec. 31, 2022: ❱ Well-care exam: Members who are 3 to 21 years of age can earn a $20 gift card for getting a well-care exam. ❱ Cervical cancer screening (Pap test): Female members who are 21 to 64 years of age can earn a $25 gift card for getting their cer vical cancer screening. ❱ Asthma exam: Members who are 5 to 64 years of age and have asthma can earn a $40 gift card for getting an asthma checkup. You can find the member reward forms at www.goldcoasthealth plan.org. Go to the “For Members” tab, then click “Member Resources” and “Member Rewards.” Call your doctor and set up your next health care visit. Have your doctor sign your form once you have completed your exam. Mail or fax your form to GCHP to be processed. ❱ Mail: Gold Coast Health Plan Attn: Quality Improvement PO Box 9153, Oxnard, CA 93031-9826 ❱ Fax: 1-805-248-7616 For questions, email the Quality Improvement Department at Quality Improvement@goldchp.org. GCHP has free health education materials available in English and Spanish. Call 1-805-437-5718 Monday through Friday, 8 a.m. to 5 p.m. to request materials. If you use a TTY, call 1-888-310-7347.
24-Hour Advice Nurse Line: 1-877-431-1700/TTY 711 4 Watch a video to learn about the program! To learn more about the new benefit and services available to you through California Advancing and Innovating Medi-Cal (CalAIM), visit our website. We made a video that gives an outline of CalAIM. You will learn about: ❱ The new Enhanced Care Management (ECM) benefit. ❱ New Community Supports (CS) services. ❱ How to get these services. Visit www.goldcoasthealthplan.org to watch. New Medi-Cal program The Medi-Cal program is changing to help members in new ways. The new California Advancing and Innovating Medi-Cal (CalAIM) program includes a new benefit called Enhanced Care Management (ECM), and new services called Community Supports (CS). ECM is available to members who are: ECM meets members where they are–on the street, in a shelter, in their doctor’s office, or at home. Participants will have one care manager who will coordinate their care. This makes it easy to get the right care at the right time. CS are alternatives to traditional health care services or settings. GCHP offers: ●Housing services to help: • Find housing. • Navigate housing benefits. • Pay for some costs when moving in (like deposits). • Stay in housing once moved in. ●Recuperative care. This is for continued care in a safe, clean place after a hospital stay. Members may be eligible for healthy meals to keep from getting sicker or going back in the hospital if they: ●Have congestive heart failure. ●Have had a hospital stay. You may be contacted about ECM or CS services if you qualify. You can also call GCHP at 1-888-301-1228 Monday through Friday, 8 a.m. to 5 p.m., (if you use a TTY, call 1-888310-7347) or talk to your doctor. Participating in ECM or CS is voluntary. Members can decline these services. ●Experiencing homelessness. ●High users of unnecessary services at an emergency department, hospital, or short-term skilled nursing facility. ●Adults with a serious mental illness or substance use disorder. ●Adults and youth who are incarcerated and transitioning into the community.
Member Services: 1-888-301-1228/TTY 1-888-310-7347 5 Call… GCHP Member Services 1-888-301-1228, TTY: 1-888-310-7347 Monday to Friday, 8 a.m. to 5 p.m. ●To change your Primary Care Provider (PCP). ●To request a new GCHP ID card. ●For help with a bill from a medical provider. ●To check the status of an authorization. ●When you need help getting timely appointments. ●If you want to file a grievance. ●To schedule an interpreter at your medical appointment. Appointments with your PCP Call the phone number on your GCHP ID card. Mental Health Assistance Beacon Health Options (Monday to Friday, 8 a.m. to 8 p.m.) 1-855-765-9702, TTY 1-800-735-2929 Pharmacy/Prescriptions Medi-Cal Rx (24 hours a day, seven days a week) 1-800-977-2273, TTY 711 Vision Services VSP (Monday to Friday, 8 a.m. to 5 p.m.) 1-800-877-7195, TTY 1-800-428-4833 Transportation Ventura Transit System (VTS) (24 hours a day, seven days a week) 1-855-628-7433, TTY 711 Dental Care Medi-Cal Dental (Monday to Friday, 8 a.m. to 5 p.m.) 1-800-322-6384, TTY 1-800-735-2922 For Medi-Cal eligibility or to change your address Human Services Agency (HSA) (Monday to Friday, 8 a.m. to 5 p.m.) 1-888-472-4463, TTY 1-800-735-2929 Stay covered! Medi-Cal renews once a year, unless you have a change that affects your eligibility during the year. Renewals are done by the Ventura County Human Services Agency (HSA), not by Gold Coast Health Plan (GCHP). Here is how it works: ●HSA will first try to automatically fill out your renewal by using information from electronic data sources. ●If you have Medi-Cal through the Social Security Administration (SSA) because you get Supplemental Security Income (SSI), you have a different process. The SSA will let you know if they need any information from you. If HSA or SSA needs information from you to renew your benefits, they will send you a redetermination packet or ask for verification. If you need help with the annual re-enrollment, call Interface MediCal Program at 1-833-607-2650 or Mixteco/Indigena Community Organizing Project (MICOP) at 1-805-215-0730. If you lose your Medi-Cal benefits, you will not be a GCHP member anymore. If this occurs, you may reapply for Medi-Cal, but you may not have coverage for some time. IT IS IMPORTANT to return your renewal by the due date. If you don’t, your Medi-Cal benefits may end. If you have moved since you enrolled, call HSA at 1-888-472-4463, Monday through Friday, 8 a.m. to 5 p.m., and give them your new address. If you use a TTY, call 1-800-735-2929.
6 24-Hour Advice Nurse Line: 1-877-431-1700/TTY 711 Men’s health: Taking care of yourself It’s never too late to make your health a priority. Here are six smart things men can do to stay on top of their health: 1. Schedule a checkup. You don’t need to be sick to visit your doctor. A checkup gives you a chance to learn more about your health and what steps you should be taking. 2. Say yes to screening tests. Screenings look for signs of serious diseases, like cancer and heart disease, before symptoms appear. Your doctor can tell you what tests are best for you. 3. Get your shots. Adults need vaccines for things like tetanus, shingles, and the flu. Staying up-todate can help keep you from getting sick. 4. Quit risky habits. Ask your doctor for help to quit smoking, drinking, or using drugs. There are treatments that can help. 5. Step on the scale. Eating well and staying active can help you manage your weight. Doing so can also help lower your risk for problems like diabetes and heart disease. 6. Manage your mental health. If you feel stressed, anxious or depressed, tell your doctor about it. There’s no shame in asking for help– and treatment works. Sources: American Academy of Family Physicians; U.S. Department of Health and Human Services How to quit smoking or vaping You can quit smoking or vaping and live a healthy life. There are many services available to help you quit. Take the first step and call Kick It California at 1-800-300-8086 (7 a.m. to 9 p.m. Monday to Friday; 9 a.m. to 5 p.m. Saturday) or visit www.kickitca.org. You can also talk to your doctor about what method may be right for you. Nondiscrimination notice Discrimination is against the law. Gold Coast Health Plan (GCHP) follows state and federal civil rights laws. GCHP does not unlawfully discriminate, exclude people or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity or sexual orientation. GCHP provides: ●Free aids and services to people with disabilities to help them communicate better, such as: ●Qualified sign language interpreters. ●Written information in other formats (large print, audio, accessible electronic formats and other formats). ●Free language services to people whose primary language is not English, such as: ●Qualified interpreters. ●Information written in other languages. If you need these services, call GCHP between 8 a.m. and 5 p.m. at 1-888-301-1228. If you cannot hear or speak well, please call 1-888-310-7347. Upon request, this document can be made available to you in braille, large print, audiocassette or electronic form. To obtain a copy in one of these alternative formats: ●Call: Gold Coast Health Plan 1-888-301-1228. If you use a TTY, call 1-888-310-7347 or 711. ●Or write to: Gold Coast Health Plan Attn: Member Services 711 E. Daily Drive, Suite 106 Camarillo, CA 93010
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