Top 4 LA Care Health Plan For Your Health Insurance

LA Care Health Plan

In 1997, the Los Angeles County Local Initiatives Health Authority (LA Care Health Plan) started offering its services to the public as a registered health insurance provider.

Four health coverage programs, including Medi-Cal, are provided by the organization to low-income residents in Los Angeles County.

An Overview of the Company

The State of California established LA Care Health Plan as the Local Initiative Health Authority for Los Angeles County to provide health care services to Medi-Cal managed care enrollees, uninsured children, and other low-income residents of Los Angeles County.

History

For 25 years, LA Care Health Plan has provided excellent coverage to residents of Los Angeles County.

Together with our Plan Partners, we have ensured that our more than 2.5 million members have had access to quality medical care and that the safety net of medical professionals necessary to treat them has been maintained.

Promoting health equality for our members and their communities is another priority for LA Care.

Based on our Statement of Principles for addressing social injustice and structural racism, we have established a Health Equity Department and are working to implement its recommendations.

The Elevating the Safety Net Initiative, funded at $155 million, was established to deal with an impending physician shortage.

We have 11 Community Resource Centers located around Los Angeles County, thanks to our partnership with Blue Shield of California Promise Health Hope, and we plan to add three more by the end of 2023 to serve our members better.

In addition, LA Care has been there for its patients and doctors for the last two years while we’ve dealt with the worldwide COVID-19 epidemic.

Without the help of our numerous collaborators, none of this would be possible.

Read on for a brief retrospective of some of our history’s most pivotal times.

As we continue to improve health services around Los Angeles, we anticipate future success on behalf of our local communities.

The Origins and Organization

A paper titled “Expanding Medi-Cal Managed Care: Reforming the Health System – Protecting Vulnerable Populations” was published by the State Department of Health Services in 1993.

A locally organized Medi-Cal managed care plan (local initiative health plan) will be developed in Los Angeles County as part of the “Two-Plan Model,” directly competing with “commercial plans” for enrollments in the Medi-Cal managed care program.

A competitive selection procedure resulted in the state selecting Health Net of California as the “commercial plan,” the formation of LA Care Health Plan as the Local Initiative Health Authority of Los Angeles County, and the implementation of the Two-Plan Model in Los Angeles County.

LA Care’s seven health plan partners at the time of its start in 1997 were Blue Cross of California (now Anthem), Community Health Plan (CHP), Kaiser Permanente, Care 1st, UHP, Tower Health Plan, and Maxicare.

Direct participation in Medi-Cal by LA Care began in 2006. There are now three different health insurance providers that work with LA Care: the Blue Shield of California Promise Health Plan, Kaiser Permanente, and Anthem Blue Cross (formerly Care 1st).

LA Care’s Healthy Families program, the Golden State’s answer to the federal Children’s Health Insurance Program (CHIP), began operations in 1998.

LA Care’s Healthy Kids program, serving children under the age of five and funded in part by First 5 LA and the Children’s Health Initiative of Greater Los Angeles, was established in 2003.

Healthy Kids was created to provide health coverage to low-income and undocumented families that are not eligible for Medi-Cal or Healthy Families.

Age eligibility was extended to include those between 6 and 18 in 2004. In light of SB 75, a California legislation that went into effect in May 2016 and provided full-scope Medi-Cal coverage to all low-income children regardless of immigration status, LA Care stated that the Healthy Kids programs would stop at the end of 2016.
In order to serve qualified people for both Medi-Cal and Medicare, LA Care introduced the Medicare Advantage Special Needs Plan (SNP) in 2008.

As of December 31, 2014, LA Care no longer offered their Medicare SNP since the company opted to join the Cal MediConnect dual-eligible trial program.

For the Cal MediConnect program, LA Care started accepting passive enrollment in January 2015.

Cal MediConnect’s coordinated care approach inside a single health plan will foster better health outcomes and an enhanced quality of life for dual-eligibles.

To better serve the people of Los Angeles County, Covered California contracted with a new health insurance provider, LA Care Covered, on October 1, 2013.

LA Care Health Plan

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La Care Health Plan Provider portal

You have reached the Los Angeles Care Provider Portal for Non-Contracted Providers, a valuable online resource for checking on patient benefits and eligibility, claim status, and more.

Log in to:

  • To check a patient’s current eligibility and benefit information,
  • Checking in on patient claims
  • Download the forms.
  • Reports, coverage history, and other resources are available at this link.

Please sign in if you are a Contracted Provider.

Sign Up to Be an L.A. Healthcare Provider

LA Care Health Plan

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LA Care Health Plan Provider Services

Please contact our Member Services team at 1-888-839-9909 if you have any questions as an L.A. Care member (TTY 711).

If you have any questions about your coverage, please get in touch with the appropriate Member Services.

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Governance

The Los Angeles County Department of Health Services is one of 13 members on the LA Care Board of Governors, including representatives from consumers, community clinics, physicians, hospitals, federally qualified health centers, providers of care for children, and the Los Angeles County government.

The LA Care enrollees vote for two consumer representatives to fill the two open seats. LA Care is one of the only publicly funded health care programs with consumer members on its board of directors who also have a voice in policy decisions.

Fifteen consumer advisory groups advise the board of governors across Los Angeles County.

Giving to the community

In 2001, LA Care established the Community Health Investment Fund.

Since its inception, the organization has provided approximately $132 million in grants and other forms of financial assistance to the health care safety net to boost local communities’ health and provide more people without access to medical care with access to health insurance.

Health information technology initiative grants help clinics buy and implement technologies like disease registries and electronic health records; oral health initiative grants increase access to dental care for low-income Angelenos, and the Tranquada Awards provide infrastructure support for safety net clinics.

Twenty million dollars worth of funding was pledged by LA Care in 2017 to help those living on the streets in Los Angeles County.

The agreement is for five years with the nonprofit organization Brilliant Corners, which assists the county’s Housing for Health initiative.

Resource Centers for the Community

Community resource centers are maintained jointly by the LA Care Health Plan and Blue Shield of California to provide members with enrollment in local and state aid programs and other community services.

You may now visit one of the centers in Pomona, Lynwood, East LA, or Palmdale. There will be a total of 14 centers as part of a five-year, $146 million effort by the two health organizations to increase access to community health services in Los Angeles County.

LA Care Health Plan once ran Family Resource Centers in Los Angeles. Free health education, exercise, and nutrition programs were offered to the public in East L.A., Lynwood, Inglewood, Boyle Heights, Pacoima, and Palmdale, California.

Programs

Advocating for Health-Related IT

With the support of a federal grant received in April 2010, LA Care opened HITEC-LA, a Health Information Technology Regional Extension Center (REC), to assist medical professionals in Los Angeles County in adopting and using Electronic Health Records (EHRs).

Grant requirements state that HITEC-LA is the only REC operating in Los Angeles County. Grant funding was provided by the American Recovery and Reinvestment Act of 2009’s Health Information Technology for Economic and Clinical Health Act (HITECH Act).

Taking Care of Physician Shortage

Elevating the Safety Net is a multi-year program established by LA Care in July 2018 to increase the number of primary care doctors working in the Los Angeles County safety net.

Scholarships for medical school, debt repayments for medical school, and a recruiting program to assist clinics and practices with physician wage subsidies, sign-on incentives, and relocation fees have all been funded by the LA Care Board of Governors.

In 2021, LA Care donated $3,2 million to the David Geffen School of Medicine at UCLA, the AltaMed Health ServicesCorporation, the White Memorial Medical Center Charitable Foundation, and Charles Drew University of Medicine Science to provide 25 resident places.

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