Gold Coast Health Plan Launches Total Care Advantage
Gold Coast Health Plan (GCHP) has unveiled an innovative approach to healthcare with the introduction of Total Care Advantage, a custom plan catering specifically for individuals holding both Medi-Cal and Medicare coverage. This new initiative addresses the need for integration of care within Ventura County, allowing members to have a singular point of contact for their healthcare needs.
Understanding Total Care Advantage
Total Care Advantage is a Medicare Advantage Special Needs Plan (HMO D-SNP) tailored for low-income seniors and those with disabilities, specifically targeting Medi-Medi members. By choosing this plan, members can expect coordinated care designed to facilitate access to services, manage appointments effectively, and provide assistance in handling chronic health conditions.
Benefits of the New Plan
Dr. Felix Nuñez, CEO of GCHP, expressed enthusiasm about breaking down barriers that often lead to fragmented care. He stated, "We are thrilled to launch a coordinated health plan for our community, allowing for seamless healthcare experiences. This plan has been developed by local professionals who have built trust with the community over the years." This sentiment reflects GCHP's long-standing commitment to enhance healthcare services and support our members.
Community Impact and Future Enrollment
In 2026, the Total Care Advantage plan will be available for enrollment across various counties, aligning with a statewide initiative to streamline care for dual-eligible members through the California Advancing and Innovating Medi-Cal (CalAIM) program. This launch is part of a broader effort to enrich healthcare delivery and elevate the welfare of participants.
What Members Can Enjoy
With approximately 27,000 Medi-Medi members previously reliant on various Medicare plans, Total Care Advantage aims to consolidate services. Members can anticipate receiving an extensive range of Medi-Cal benefits, including dental, vision, and transportation services, alongside traditional Medicare coverage for inpatient hospital stays and skilled nursing facilities. Further, the plan offers supplemental benefits such as hearing aids, gym memberships, and other community support services – all without the burden of premiums or co-pays.
Eligibility Criteria for Enrollment
Individuals wishing to enroll in Total Care Advantage must meet several key requirements:
- Reside in Ventura County.
- Be 21 years or older.
- Possess both Medicare Parts A and B.
- Have full-scope Medi-Cal coverage.
The open enrollment period for this plan runs from October 15 to December 7, providing ample opportunity for eligible participants to enroll. Moreover, those who qualify have the option to enroll beyond this window at any time throughout the year.
Continuous Support for Members
Eve Gelb, GCHP's Chief Innovation Officer, underscored the importance of integrating all benefits to significantly uplift the quality of life for members. She stated, "By merging all healthcare benefits into one streamlined plan, we can provide greater support tailored to the unique needs of our community." GCHP is excited to enrich healthcare provision and fulfill the needs of those who have previously depended on fragmented coverage.
About Gold Coast Health Plan
Gold Coast Health Plan has been a dedicated provider of Medi-Cal services since its establishment in 2011, currently serving approximately 240,000 members throughout Ventura County. With a robust network of healthcare professionals ranging from primary care physicians to behavioral health specialists, GCHP focuses on improving health outcomes for diverse populations, including vulnerable groups like seniors and young children. To find out more about the accessible healthcare options available, interested individuals are encouraged to explore GCHP's resources.
Frequently Asked Questions
What is Total Care Advantage?
Total Care Advantage is a Medicare Advantage Special Needs Plan designed for individuals who are eligible for both Medi-Cal and Medicare.
Who can enroll in Total Care Advantage?
Eligibility includes residents of Ventura County who are 21 years or older and possess both Medicare Parts A and B, plus full-scope Medi-Cal.
What benefits does Total Care Advantage offer?
Members enjoy integrated benefits from Medi-Cal and Medicare, including healthcare services, dental and vision care, plus additional perks like hearing aids and gym membership.
When is the open enrollment period?
The open enrollment for Total Care Advantage is from October 15 to December 7, with options for continuous enrollment throughout the year for qualified individuals.
How does Total Care Advantage improve care access?
The plan combines both Medi-Cal and Medicare benefits into a single integrated program, providing coordinated care and reducing the barriers to accessing necessary healthcare services.
