FIND A PROVIDER
To find a provider near you, click on one of the links below
REQUEST A PRINT COPY OF THE DIRECTORY
Central Health Medicare Plan does not automatically send members a printed copy of the Provider Directory or Pharmacy Directory. If you need help finding a network provider and/or pharmacy, please call 1-866-314-2427, TTY/TDD users 711. If you would like a Provider Directory or Pharmacy Directory mailed to you, you may call the number above, request one at the website link below, or email firstname.lastname@example.org.
Request a provider directory or pharmacy directory
This directory is current as of September 01, 2023.
This directory provides a list of Central Health Medicare Plan’s current network providers for Los Angeles County, Orange County, Riverside County, San Bernardino County, Ventura County, Alameda County, Contra Costa County, Fresno County, San Joaquin County, San Mateo County, and Santa Clara County.
To request a hard copy of Central Health Medicare Plan’s provider directory, please call our Member Services Department at 1-866-314-2427, 7 days a week from 8:00am to 8:00pm (PT). Central Health Medicare Plan will mail a hard copy of the provider directory to you within three (3) business days of your request. Central Health Medicare Plan may ask whether your request for a hard copy is a one-time request or if you are requesting to receive the provider directory in hard copy permanently.
If you request it, your request for hard copies of the provider directory remains until you leave Central Health Medicare Plan or request that hard copies be discontinued.
This directory provides a list of Central Health Medicare Plan's network providers.
Use this directory to find Central Health Medicare Plan’s network providers for your care needs. Network Providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities that have an agreement with us to accept our payment and any plan cost sharing as payment in full. We have arranged for these provider to deliver covered services to members in our plan.
You will have to choose one of our network providers listed in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care services from your PCP. Your PCP is a physician who meets state requirements and is trained to give you basic medical care. You will get your routine or basic care from your PCP. Your PCP can also coordinate the rest of the covered services you need. In most cases, you must see your PCP to get a referral before you see any other health care provider.
The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from out-of-network providers.
Central Health Medicare Plan maintains a standard for appointment wait times for all network providers. Members should receive care from network providers within the following timeframes:
Out-of-network providers are providers that are not part of Central Health Medicare Plan. If you use out-of-network providers, you may have to pay more. Care or services you get from out-of-network providers will not be covered, except for ambulance services, emergency care, including post-stabilization care, urgently needed care, renal dialysis (kidney), and any services which were ordered covered through an appeals process.
If an out-of-network provider sends you a bill for covered services that you think should be paid by our plan, DO NOT pay the bill. Please contact Member Services at 1-866-314-2427. TTY users call 711. We will ask you to send the bill to us so that we can process and determine the amount you owe, if any. If you have already paid for any medical care that we cover, we will reimburse you for our share of the cost.
When you have a “medical emergency,” you believe that your health is in serious danger. A medical emergency can include severe pain, a bad injury, a sudden illness, or a medical condition that is quickly getting much worse.
If you have a medical emergency:
After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan. If your emergency care is provided by out-of-network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances allow.
“Urgently needed care” is a non-emergency situation when:
Whenever possible, you must use our network providers when you are in the plan’s service area and you have an urgent need for care. In most situations, if you are in the plan’s service area, we will cover urgently needed care only if you get this care from a network provider. If the circumstances are unusual or extraordinary, and network providers are temporarily unavailable or inaccessible, our plan will cover urgently needed care that you get from a non-network provider.
You must use network providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor Central Health Medicare Plan will be responsible for the costs.
The counties in our service area are listed below.
Contra Costa County
Los Angeles County
San Bernardino County
San Joaquin County
San Mateo County
Santa Clara County
The PCPs in this directory are organized alphabetically by the cities where they reside, and further listed in alphabetical order by last name within each city. By looking up the city in which you reside, you will be able to find the physicians listed in your area. The specialty care providers (specialists) are organized alphabetically by the physician groups they belong to. If there is a particular plan specialist that you want to use, check first to be sure your PCP makes referrals to that specialist. Your PCP choice may restrict you to a specific group of specialists. If you have questions about Central Health Medicare Plan or require assistance in selecting a PCP, please call our Member Services Department at 1-866-314-2427, 7 days a week, 8:00 A.M. to 8:00 P.M. (PT). TTY users should call 711. You can also visit www.centralhealthplan.com.
* Providers noted with an asterisk accept Medicare and Medi-Cal.
† Providers noted with this symbol are not currently accepting new patients.
This directory is current as of 09/01/2022.
Our business hours are 7 days a week
from 8:00am to 8:00pm (PT).
Our business hours are 7 days a week from 8:00am to 8:00pm (PT).
PO Box 14244, Orange, CA 92863