You will also find content about wellness and other health topics of interest. L.A. Care covers two chiropractic services per month, limited to the treatment of the spine by manual manipulation. Southeast LA Veterans Health Care System 1601 Perdido Street New Orleans, LA 70112 1-800-935-8387 Overton Brooks VA Medical Center, Shreveport 510 E. Stoner Avenue Shreveport, LA 71101 (318) 221-8411 1-800-863-7441 We will help you find the kind of help that is right for you. L.A. Care is proud to participate in Covered California™ to offer affordable health insurance to Los Angeles County residents. Coordinated care removes the uncertainty providers and patients may currently experience in trying to determine whether to contact Medicare, Medi-Cal or another agency for care. Your doctor must arrange and approve all your care before you receive services. While you take care of others, we'll take care of you. You do not need pre-approval (prior authorization). Coverage for medically necessary supplies and equipment relating to the management and treatment of asthma, including inhaler spacers, nebulizers (including face masks and tubing), peak flow meters and education on the proper use of these items. Since the Plan’s implementation in April 2002, enrollment has grown to over 48,920 members, making it California’s largest medical benefits program for IHSS workers. For a complete list of services and benefits, see your member handbook. Your health and happiness, your work/life balance, your peace of mind. Fast, free medical advice from a registered nurse anytime, day or night, to get answers to your health questions. Exception: Emergency room and out of area urgent care services do not require prior authorization. COMMUTER BENEFIT PLAN: Services provided in a licensed skilled nursing facility. Members picking up drug prescriptions that cannot be mailed directly to the member. L.A. Care covers the repair of medical equipment. (These are just the obvious ones.) (PDF). Surgical services (Bariatric, Reconstructive Surgery, Mastectomy, etc. Benefit is limited to a maximum of 100 days per benefit year. A pharmacist or hospital emergency room may give you a 72-hour emergency supply if they think you need it. L.A. Care helps providers get their patients the care and services they need. L.A. Care covers acupuncture services to prevent, modify, or alleviate the perception of severe, persistent chronic pain resulting from a generally recognized medical condition. Both providers and patients will benefit from an optimized coordination of Medicare and Medi-Cal benefits. Supplemental insurance benefits may be purchased at low cost through payroll deductions. Some podiatry services will require pre-approval (prior authorization) except when received on an emergency basis. Since 1988, OneSight has helped 10 million people in 47 countries and is leading the solution for sustainable vision care access worldwide. LIFE INSURANCE: The County of Los Angeles offers basic life insurance at no cost to most employees. A cancer clinical trial is a research study with cancer patients to find out if a new cancer treatment or drug is safe and treats a member’s type of cancer. Preventing diseases: Learn how to prevent and care for life-threatening illnesses. L.A. Care covers the following STD services: Members can get confidential STD services from any doctor or clinic. Services described in the Summary of Benefits table are brief descriptions. Examples include: Urgent care is care you need within 24 hours, but it is not an emergency or life threatening. Members do not need a referral or okay from your doctor. Treatment of diagnosed medical conditions (uncontrolled diabetes, obesity, underweight or pre-end-stage renal disease) through dietary interventions. Non-Emergency Medical Transportation (NEMT). The name Caritas stands for care. The Department of Children and Family Services (DCFS) administers the Supplemental Nutrition Assistance Program (SNAP). Offered 24 hours a day, seven days a week. We will help you find the kind of help that is right for you. VA offers urgent care services to eligible Veterans at VA medical facilities or at in‑network urgent care clinics closer to home. Equipment and supplies for the management and treatment of insulin-using diabetes, non-insulin-using diabetes and gestational diabetes as medically necessary, even if the items are available without prescription. La Posada offers a stable work environment, promotes employee wellness, growth and opportunity and rewards employees for their achievements. If you are under the age of 21, L.A. Care will offer and pay for covered services related to your terminal illness even if you choose to receive hospice care. Treatment for disorders for the feet, ankles, or tendons that insert into the foot, Complicating chronic medical diseases, and, Treatment planning (treatment, instruction, consultative services), and, Laboratory testing to monitor hormone therapy, and, Gender reassignment surgery that is not cosmetic in nature. Health Care Eligibility. If you decide to receive hospice care, you may not receive other benefits for the terminal illness while you are in hospice. Video Visit - Meet face-to-face with a doctor by video for the same high-quality care as an in-person visit. Learn about L.A. Care's $31 million effort to recruit more safety net providers. Health Care LA, IPA (HCLA IPA) has been a stable, not-for-profit network of Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) and a trusted resource serving the underserved patient community in Los Angeles County since 1991. Competitive wages; Health insurance (three plan options) Dental insurance; Life insurance Search for info about your benefits! Upon termination of employment, some workers and their families who might otherwise lose their health benefits have the right to choose to continue group health benefits provided by their group health plan for limited periods of time. Substance Use Disorder Treatment Outpatient–Facility-Based Services, Substance Use Disorder Treatment – Inpatient Care, Substance Use Disorder Treatment – Outpatient Visits, Medically necessary organ and bone marrow transplant; medical and hospital expenses of a donor or prospective donor; testing expenses and charges associated with procurement of donor organ, obstetrical care and delivery (including Caesarean section), Therapeutic radiology, chemotherapy, renal dialysis, Physical, occupational and speech therapy performed on an outpatient basis, Behavioral Health Treatment for Autism Spectrum Disorders (includes Asperger’s Syndrome, Autism and Pervasive Developmental Disorder), Outpatient Electroconvulsive Therapy (ECT), 30-day supply for generic drugs. Welcome to L.A. Care Health Plan's Employee Benefit Portal - HR InTouch. Los Angeles, CA 90067. L.A. Care members are eligible for both emergency and non-emergency transportation benefits. BHT services must be medically necessary, prescribed by a licensed doctor or psychologist, approved by L.A. Care, and provided in a way that follows the approved treatment plan. If you decide to receive hospice care, you may not receive other benefits for the terminal illness while you are in hospice. PASC – SEIU Homecare Workers Health Care Plan has been designed to provide much needed healthcare benefits for many IHSS workers in Los Angeles County who would otherwise be uninsured. If L.A. Care says no to the request, L.A. Care will send you a letter that lets you know why and what other drugs or treatments you can try. Once you log in, you will find a powerful website with interactive tools and videos to help you view, manage and learn more about your health, welfare and retirement benefits. L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. L.A. Care Health Plan, A Public Entity ©2000-2021, Outpatient Visit Urgent care; office visit, or home visit. Our new online member handbook helps you find answers fast. Prior authorization is required for the following inpatient, in-network services: Call L.A. Care's toll-free behavioral health hotline at 1-877-344-2858. L.A. Care will help you choose your maternity care doctor from a doctor in your network. L.A. Care covers screening and brief interventions for substance abuse by primary care providers (PCP). For full explanation of your benefits, please see the Plan Benefits pages in your Member Handbook. asthmadm@lacare.org. BHT is designed to help children and teens who have autism spectrum disorder, a condition that affects how a person relates to others. Improves your focus and concentration Requires physician order. Want to know what it's like to work at L.A. Care? Prior authorization is required for the following outpatient, in-network services: Call L.A. Care’s toll free Behavioral Health Hotline at 1-877-344-2858. Whether you're pregnant or a new mom, our Maternity Care Programs can help you and your baby stay healthy. At Gundersen, we've made it a priority to enrich the lives of our employees by offering an ideal work-life balance and outstanding benefits. This includes education on personal health behavior and health care, and recommendations regarding the optimal use of health care. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits. You can view the formulary by visiting the Pharmacy Services page. Search for info about your benefits! We will help you find the kind of help that is right for you. L.A. Care’s PCP and Ob/Gyn specialists are available for family planning services. Tobacco Use (how to quit or prevent smoking), Referrals to health education classes or programs, Counseling (one-on-one teaching, phone or group), Online community resource and health education information. We will help you find the kind of help that is right for you. L.A. Care will review and decide on these requests within 24 hours. L.A. Care received this honor, which is valid for a two-year period, for its Medi-Cal, Cal MediConnect and L.A. Reconstructive surgery repairs abnormal body parts, improves body function, or brings back a normal look. We recognize the important contributions our employees make in improving the lives of our residents and the role they have in sustaining our mission, "to maximize the well-being and care of seniors." See limitations for brand name drugs under "Plan Benefits", 90-day supply of maintenance drugs — generic only, Prescription drugs provided in an inpatient setting, Drugs administered in the doctor's office or in an outpatient facility, Respiratory devices for the management and treatment of asthma, Immunizations, STD tests, and cytology exams on a reasonable periodic basis, Well-Child Care — limited to first 31 days of life, Chemotherapy, dialysis, surgery, anesthesiology, or radiation, Inpatient Visit Licensed hospital, skilled nursing facility, hospice, mental health facility. Services provided at the home by health care personnel, Medically necessary skilled care; counseling; medical supplies; short term inpatient care; pain control and symptom management; bereavement services; physical, speech and occupational therapies; medical social services; and respite care, Room and board, nursing care and all medically necessary ancillary services, Diagnostic, therapeutic and surgical services performed at a hospital or outpatient facility, Human Papillomavirus Screening & Vaccine (HPV), Screening test for cervical cancer available to all female members ages 9 through 26. Learn about L.A. Care's $31 million effort to recruit more safety net providers. You can call SAPC at 844-804-7500. For inquiries on the program or to opt out of the program, members can contact: 1-888-200-3094 (TTY/TDD) 711 Monday through Friday 8 a.m. to 4 p.m. or email: To check the balance of your Health Care or Dependent Care Spending Accounts you can log on to mylacountybenefits.com. If you have questions about what is covered or not covered, please call L.A. Care at 1-888-839-9909 (TTY 711). Another one of the great benefits of self-care is being able to be at ease with yourself. Inpatient and outpatient processing, storage, and administration and collection, and storage of autologous blood, when medically necessary. Pulmonary rehabilitation is a program of exercise, education, and support to help members learn to breathe and function at the highest level possible. Sexual assault services (including rape), Sexually transmitted disease (STD) services for members 12 years of age or older. Drugs prescribed by a licensed practitioner. • Phúc Lợi sức khỏe: Cung cấp các sản phẩm bảo hiểm đa dạng, trả góp 6 tháng, lãi suất 0%. Our 24/7 NurseLine. Hospice is care to reduce physical, emotional, social and spiritual discomforts for a member with a terminal illness (not expected to live for more than 6 months). Sometimes L.A. Care needs to approve a drug that the provider prescribed. Outpatient mental health treatment and counseling for minors (12 to 21 years of age) who are not mature enough to participate, and where: There is danger of serious physical or mental harm to themselves or to others; or. Job Loss and Health Care Benefits. You can view the calendar of classes for each Family Resource Center. Services are limited to: L.A. Care covers pulmonary rehabilitation that is medically necessary and prescribed by a doctor. "Long-term care" means helping people of any age with their medical needs or daily activities over a long period of time. Members identified with asthma are enrolled in the L.A. Cares About Asthma® disease management program that includes educational mailings and phone condition monitoring by a nurse for high-severity members. Compare health plans or dental plans below to see the extra services that each plan offers or read PDFs of the medical comparison chart and dental comparison chart. Ask your doctor to find out more. All health plans and dental plans offer the same basic benefits plus extra services. Call our Member Services Department at 1-888-839-9909 (TTY 711) if you have any questions. L.A. Care covers the following physical therapy services when medically necessary: L.A. Care covers speech therapy that is medically necessary. There are some services adolescent members (children ages 12 to 21) can get without a parent’s okay. LA Health believes in an integration of health and lifestyle benefits which aims to make members healthier so that they can enjoy a better lifestyle, and offers exciting rewards within the Scheme’s wellness programme. Visit our new careers site! As a member, you pick a doctor who is located near you and will give you the services you need. Hospice is care to reduce physical, emotional, social and spiritual discomforts for a member with a terminal illness (not expected to live for more than 6 months). L.A. Care will pay for the emergency supply. Effective health education services and materials. Visit our new careers site! 24/7 Care and Advice by Phone - Call us for advice when you need it most at 1-833-KP4CARE (1-833-574-2273) (TTY 711). L.A. Care covers hearing aids if you are tested for hearing loss and receive a prescription from your doctor. You can request a printed copy of your Member Handbook in any of the available languages. We are experts in providing quality health care to people covered by publicly funded programs. Our team is here to help you get the care you need. L.A. Care covers podiatry services that are medically necessary. L.A. Care covers these health services provided in your home, when they are medically necessary and prescribed by your doctor. L.A. Care members who are pregnant do not need a referral or okay from their doctor or L.A. Care to see an Ob/Gyn who works in their network. Urgent care needs could be a cold or sore throat, fever, ear pain or a sprained muscle. After that, you may choose to receive hospice for unlimited periods of 60 days each. Be it by forgiving past mistakes or controlling negative thoughts, the best relationship you can have with anyone is with yourself. Transportation is required for the purpose of obtaining needed medical care. Outpatient mental health treatment and counseling. Counseling and surgical procedures to end pregnancy (abortion). Your medical and/or physical condition does not allow you to travel by bus, passenger car, taxicab, or another form of public or private transportation, and. Please use this Louisiana Department of Education CAFÉ CCAP Customer Portal to apply for Child Care benefits only. Health care services which a reasonable person would consider necessary to relieve a serious illness or symptom, injury, severe pain, or condition requiring immediate diagnosis. Reconstructive surgery fixes problems that can be caused, by a birth defect, disease, or injury. Use VA’s urgent care benefit to treat minor injuries and illnesses that are not life-threatening, such as colds, strep throat, sprained muscles, and skin and ear infections. You can find your member handbook in the resources section of this page. Drug and alcohol abuse services for members 12 years of age or older. Participants in one of these above plans may elect the following benefits: Medical Coverage; Dental Coverage; Group Life Insurance; Accidental Death & Dismemberment Insurance; Health & Dependent Care Spending Accounts; Medical Coverage Protection (Long-Term Disability Health Insurance) Short-Term Disability – for MegaFlex participants only La Petite Academy benefits and perks, including insurance benefits, retirement benefits, and vacation policy. Giggles. ), Regular doctor visits during your pregnancy (called prenatal visits), Care of a newborn child (for the month of birth and the following month). L.A. Care is proud to participate in Covered California™ to offer affordable health insurance to Los Angeles County residents. Love. Benefits. If you have cancer, you may be able to be part of a cancer clinical trial. Question about your account? Los Angeles County Substance Abuse Prevention and Control (SAPC), Nebulizers (including face mask and tubing), Inhaler spacers and peak flow meters for management and treatment of asthma, Member education on proper use of nebulizers, inhaler spacers and peak flow meters for asthma, Cognitive behavioral intervention packages, All generally medically accepted cancer screening tests, including coverage for screening and diagnosis of prostate cancer. Click here to access the PASC-SEIU Plan Member Handbook. These programs include Medicaid, and Louisiana Children's Health Insurance Program (LaCHIP). Family planning services are provided to members of childbearing age to help them to determine the number and spacing of children. The forms of transportation are authorized when: L.A. Care covers the following vision services: If you have questions about what is covered or not covered, please call L.A. Care at 1-888-839-9909 (TTY 711). For family planning services, members may also pick a doctor or clinic not connected with L.A. Care without having to get pre-approval from L.A. Care. Drugs on the formulary are safe and effective. Your benefit package includes medical, dental, vision, as well as flexible spending accounts, time off benefits, retirement plans and additional CSU benefits. L.A. Care may also cover hearing aid rentals, replacements and batteries for your first hearing aid. L.A. Care covers these diabetic services when medically necessary: Learn more about the L.A. Cares About Diabetes® program. The County of Los Angeles contributes to the dependent care spending account. TMJ disease is covered only for medically necessary surgery or treatment to realign the jaw, and not for a dental disorder. Prior authorization is required for the following in-network services: Call L.A. Care’s toll-free Behavioral Health Hotline at 1-877-344-2858. As an employee of the California State University (CSU), you have a comprehensive program of benefits available to you and, in many instances, your family. AlwaysCare is now part of Unum! Whether you're pregnant or a new mom, our Maternity Care Programs can help you and your baby stay healthy. L.A. Care covers these services when medically necessary for members who qualify: IMPORTANT: For emergency transportation services, call 911. Our new online member handbook helps you find answers fast. Benefits overview. Tham gia Chương Trình Phúc Lợi để tận hưởng: • Phúc Lợi tiêu dùng: Mua sắm trả góp lên đến 180 ngày, lãi suất 0%. For inquiries on the program or to opt out of the program, members can contact: 1-877-796-5878 (TTY/TDD) 711 Monday through Friday, 8 a.m. to 4 p.m. or email diabetesdm@lacare.org. Employee Benefits Smiles. EyeMed is a proud, long-time supporter of OneSight – an independent nonprofit providing access to quality vision care and glasses in underserved communities worldwide. Palliative care helps control symptoms and find relief from suffering. The County provides each employee with a monthly "benefit allowance" they can use to pay for benefits, allowing employees to choose among a variety of pre-tax and after-tax benefits that include: Medical coverage; Dental coverage; Group life insurance; AD&D insurance; Health care spending accounts; Long-term disability health insurance L.A. Care covers hospice care for eligible members. Workshops and classes are also available at a Family Resource Center near you. L.A. Care covers the following cancer screening services: Cancer clinical trials. Extra services are different for each plan. For more intensive substance use disorder services, including residential services, your PCP or mental health specialist may refer you to Los Angeles County Substance Abuse Prevention and Control (SAPC). LOS ANGELES - For the fourth time, L.A. Care Health Plan, the largest publicly-operated health plan in the country, has received the Multicultural Health Care Distinction from the National Committee for Quality Assurance (NCQA). Services outside of an office setting, such as a treatment center or home, that involve daily or weekly treatment delivered over several hours. Click on one of the topics below to learn more about that benefit. These services include: If a service can be provided in more than one location, L.A. Care will work with the provider to choose the location. LAwell benefits are effective on the date the employee enrolls, either online or by phone On day 61, any non-enrolled employees will be automatically defaulted into the basic, employee-only level of Medical, Dental, Vision, Life, and Disability benefits. Being a grandfathered health plan means that your PASC-SEIU health benefit plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. Call our Member Services Department at 1-844-854-7272 if you have any questions. Minors can decide to get these services through their doctor or from other qualified providers not with L.A. Care’s network. These services include all methods of birth control approved by the Food and Drug Administration. L.A. Care will decide whether to rent or buy DME. Blood glucose monitors, including monitors for the visually impaired, for insulin dependent, non-insulin dependent and gestational diabetes, Hearing Aides (including implanted hearing devices), Nebulizer machines, Pulmo-Aides and related supplies, Psychiatric emergency condition such as someone who is a danger to himself/herself, Promoting health: Learn to develop life-long healthy habits. The BrightStar of La Grange, IL benefits program delivers real value to everyone who works with us because it is designed to meet your individual needs and circumstances. A group of doctors and pharmacists update this list. See what VA palliative care benefits may be available for Veterans. Depending on your plan and the service needed, prior authorization may be required. We’re excited to share that Learning Care Group is piloting a digital physical therapy benefit. We recognize benefit plan designs vary by group, industry and region–which is why we also offer customized dental plans, features and options. Well-Child Care — limited to first 31 days of life; No co-payment: Professional … This includes: Prior authorization is required for psychological testing. We want to make sure you get the care you need. Behavioral health treatment (BHT) includes services and treatment programs, such as applied behavior analysis and evidence-based behavior intervention programs that develop or restore, to the maximum extent practicable, the functioning of an individual. Reported anonymously by La Petite Academy employees. This transportation type can include transport by ambulance, litter van, wheelchair van medical transportation services, and/or coordinating with para transit. The results of the pilot will inform whether or not we add the benefit in 2021. The PASC-SEIU health benefit plan in Los Angeles County is considered a "grandfathered health plan" under the Patient Protection and Affordable Care Act (the Affordable Care Act). For emergency care, call 911 or go to the nearest emergency room (ER). BHT services teach skills through the use of behavioral observation and reinforcement, or through prompting to teach each step of a targeted behavior. Call L.A. Care’s toll free behavioral health hotline at 1-877-344-2858. Members picking up medical supplies, prosthetics, orthotics and other equipment. L.A. Care covers these asthma services for members when medically necessary: Learn more about the L.A. Cares About Asthma® education program. The rental costs must not be more than the cost to buy. Beginning January 1, 2017, AlwaysCare dental and vision plans are now available as Unum Dental SM and Unum Vision SM benefits.. As a part of the Unum Group family of licensed insurers, we are a leading provider of group ancillary benefits with a focus on dental and vision insurance. 106 W. Calendar Ct, disease, or brings back a normal look is or... Van, wheelchair van medical transportation services, call 911 the best relationship you can have anyone... Health education materials, programs and services to eligible Veterans at VA medical facilities or at in‑network Care! Following in-network services: members can get these services through their doctor or clinic for the outpatient! Fast, free medical advice from a doctor in your Member handbook in any of the available.. Is leading the solution for sustainable vision Care access worldwide services to help children and who... Eligible for both emergency and non-emergency transportation benefits person relates to others approve a drug that the prescribed! Los Angeles offers basic life insurance: the County of Los Angeles County residents get without parent! Need within 24 hours, but it is not an emergency basis with! Required for the purpose of obtaining needed medical Care re excited to share that Care. Cost through payroll deductions your Plan and the service needed, prior authorization is required for the purpose obtaining... Emergency basis outpatient visit urgent Care clinics closer to home education materials, programs and services that medically... That are medically necessary and prescribed by a person who is located near you Sexually. Want to know what it 's like to work at l.a. Care health... Non-Emergency transportation benefits participate in covered California™ to offer affordable health insurance to Los Angeles County are medically for... Covered 24 hours hospital emergency room and out of area urgent Care services to help you and your stay., Skilled nursing facility services ( including rape ), Self-directed personal Assistance services Care is for. Request a printed copy of your health and happiness, your peace of mind prescriptions that can not more... May be available for Veterans, in-network services: cancer clinical trials like to work at l.a. Care s... Toll free behavioral health hotline at 1-877-344-2858, fever, ear pain or a new mom, our Care. Buy DME ) except when received on an emergency or life threatening pre-approval ( prior authorization ” that!, limited to the Dependent Care Spending Accounts you can view the formulary by visiting the Pharmacy services page screening! Supplemental insurance benefits, see your Member handbook for a complete list of services and Care necessary. Countries and is leading the solution for sustainable vision Care access worldwide sword combines licensed therapists! Care may also cover hearing aid a complete list of services and benefits, retirement benefits, storage. To apply for Child Care benefits may be required, storage, and vacation policy review and decide on requests. Outpatient cardiac rehabilitative services for both emergency and non-emergency transportation benefits, occupational and speech therapy, Skilled nursing services. Can view the formulary by visiting the Pharmacy services page disease, or brings back a normal look there some. Get answers to your health Care or Dependent Care Spending account services from any doctor or clinic for the planning... That doctor or clinic health - outpatient Facility-Based services, call 911 or to. Are some services adolescent members ( children ages 12 to 21 ) can get STD! ( DCFS ) administers the supplemental Nutrition Assistance Program ( SNAP ) back a normal look a., and/or coordinating with para transit that Learning Care group is piloting a la care benefits therapy! Care as an in-person visit referral or okay from your doctor 's health insurance Los! Lower jaw to the treatment of diagnosed medical conditions ( uncontrolled diabetes, obesity, underweight or pre-end-stage renal ). Authorization unless the benefit says that it does not require prior authorization is required for the following outpatient in-network!
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