Benefits Overview

California Health & Wellness offers health insurance plans with comprehensive healthcare services that suit the needs of families and individuals throughout California.

View some of California Health & Wellness' benefits below. You can also view more information in our Member Handbook.        

As a California health plan option, California Health & Wellness can help you find a provider, find local resources, plan an appointment and find transportation. Call Member Services at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

We want you to have the best quality of life you can have.

California Health & Wellness has several programs to improve the health of our members. We know this means more than just helping you to see a doctor. It also means helping you find your way through the healthcare system so you get the treatments and the social services you need. It also means helping you understand and manage your health conditions. We do this through education and personal help from California Health & Wellness staff. The goal of this service is to add to the quality of your care and help you to improve your health.

Disease management and Care Coordination are part of your health benefits and are provided to you at no cost. California Health & Wellness pays for these services.

Disease Management

California Health & Wellness works with Envolve PeopleCare to give disease management services to our members. Envolve PeopleCare Health Coaches know a lot about conditions like:

  • Asthma
  • Diabetes
  • Congestive Heart Failure
  • Hypertension
  • Smoking Cessation
  • Weight Management
  • Low Back Pain

They will talk to you about:

  • How to take medicines
  • What screening tests to get
  • When to call the doctor

They will listen to your concerns and help you get the things you need. The goal of disease management is to help you understand and take control of your condition. Better control means better health.

Care Coordination

This service is for members who have complex medical conditions. They often see several doctors. And may need help at home or treatment supplies. Conditions may include:

  • Children with special health care needs
  • Sickle Cell
  • Kidney or Renal Disease
  • HIV/AIDS
  • Traumatic Injuries
  • Hepatitis C

Our care coordinators are nurses that can help members understand their health problems. Our nurses work with the member and their doctors to help them get the care they need. The nurse can set up home health or other needed services. To get the help you need use the Care Management Referral Form.

California Health & Wellness is proud to be working with SafeLink Wireless to offer you this special, federal program. As a Member of our plan, you get all the same benefits of a SafeLink phone, plus unlimited inbound text messages and calls to California Health & Wellness member services. There is no added cost for these extras.

How to Enroll:

As a California Health & Wellness Member, you can choose who you see for your healthcare needs from our network of Providers. We have many for you to choose from. If you need help choosing a doctor, call Member Services at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

At your first visit with your PCP, s/he will do a dental screening. California Health & Wellness covers some medical services that support dental procedures. If you need dental care, your PCP will refer you to a Denti-Cal dental provider. You can also call the Denti-Cal Beneficiary Telephone Service Center at 1-800- 322-6384. 

Preventative care visits are covered by California Health & Wellness. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.

California Health & Wellness covers an annual physical for adults.

Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.

  • Birth or neonatal exam
  • 2 to 4 days for newborns discharged less than 48 hours after delivery
  • By 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • Once per year from 2 years old through 20 years old

Search for a provider in our network.

A free health information line! No matter what time it is or what day it is, you can always call our nurse advice line. When you call, you’ll speak to registered nurses who can give you advice on any health-related problem. Now they are ready and eager to help you at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

We have a special program that helps you get care, it’s called MemberConnections®. Our MemberConnections program takes both a member’s “Health” and “Wellness” very seriously.  The program can connect you to quality health education, while they can also pairing you with community social service programs. These programs can help you with food, housing and clothing.

A MemberConnections team member can talk to you on the phone or visit you in the own comfort of your home. They will be glad to talk to you about:

  • How to choose a doctor (PCP)
  • How to change doctors
  • The healthcare you get at California Health & Wellness
  • How to use California Health & Wellness’s services
  • How to get medical advice when you cannot see the doctor
  • How to live a healthy life
  • How to get shots and health screenings
  • Other healthcare problems you may have

The MemberConnections program is a helping hand for our members. To schedule a home visit or speak to a MemberConnections representative, please call Member Services at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant. We want to help you take care of yourself and your child through this whole process. Information will be given by mail, telephone and via the web. Our Start Smart staff can answer questions and give you support if you are having a problem. We can even arrange for a home visit if needed. For more information, call Member Services at 1-877-658-0305. More information on pregnancy can be found on our Pregnancy page.

We care about the health of you and your baby. We want to make sure you both grow healthy and stay healthy. You should go to your doctor as soon as you find out that you are pregnant. It is important to take your baby to the doctor after they are born. They will need shots and health screenings.

Will you be pregnant this flu season? 

Doctors recommend that you get a flu shot. Being pregnant increases your risk of getting very sick from the flu. Stay healthy during your pregnancy. Get vaccinated.

Studies show that the flu shot is safe for pregnant women.

Who needs a flu vaccination?

A flu vaccine is the best way to protect against the flu. The Center for Disease Control (CDC) recommends that all children from the ages of 6 months up to 18 years get a flu vaccine every fall or winter. Children getting a vaccine for the first time need two doses. Contact your child’s Primary Care Provider (PCP) to schedule an appointment for your child to receive their flu vaccine. If they do not have a PCP, call your health plan to choose a PCP.

  • Flu shots can be given to children 6 months and older.
  • For babies younger than 6 months, you can protect your child by getting a flu vaccine for yourself. Also encourage your child’s close contacts to get a flu vaccine. This is very important if your child is younger than 5. It is also important if your child has a chronic health problem like asthma (breathing disease) or diabetes (high blood sugar levels).
  • A nasal-spray vaccine can be given to healthy children 2 years and older. Children under 5 years old who have had wheezing in the past year or any child with chronic health problems should get the flu shot.

To learn more about other vaccinations for your children, please see the "Doctor Visits & Screenings" section of this page.

California Health & Wellness recognizes the value and contributions of our community. Diversity makes us who we are. It represents all the ways we are uniquely different. To better assist you, California Health & Wellness provides diversity and cultural support services. California Health & Wellness also provides resources. The California Health & Wellness provider directory notes providers who are accessible by ADA standards.

Interpreter Services

Interpreter services are provided free of charge to you during any service or grievance process. For material in an alternative format, contact California Health & Wellness at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

California Health & Wellness can help translate your health coverage benefits. California Health & Wellness can also help translate available services. If you need something translated into another language than English, please call California Health & Wellness. This includes sign language. We can also provide things in other formats like Braille, CD or large print.

If you need an interpreter at your medical appointment, contact California Health & Wellness seven days before your appointment. We will arrange for one to be at your appointment.

Emergency Transportation

California Health & Wellness covers ambulance transportation for emergency situations. You do not need to contact California Health & Wellness before using an ambulance for emergencies.

Non-Emergency Transportation

California Health & Wellness provides non-emergency transportation services to help members get to their health care visits.  We also cover transportation to a pharmacy for pick-up of medication after a same day doctor’s appointment. Transportation services are a free benefit for California Health & Wellness members.

Depending on where you live and your medical needs, transportation may be provided by:

  • Car, van, taxi
  • Wheelchair vehicle
  • Mass transit

Members may be able to bring an escort with them, if space permits.

If you have a medical emergency, please call 911 right away.

To learn more, or to schedule a ride, call California Health & Wellness at 1-877-658-0305, 8 a.m. – 5 p.m. Monday through Friday. Please call at least five days before your medical appointment so that we may better assist you/arrange your transportation

  • An Exam every 2 years
  • Eyeglass frames, lenses and contact lenses for members up to 21 years of age 
  • Bandaged contact lenses, based on medical necessity, for members over 21 years of age
Our vision care benefit is managed by Envolve Vision Care. Click here to find out more.

One of the most important ways to make sure you get the healthcare you deserve is through a Medical Home. This means where you go to get medical care on a regular basis, your doctor. Here are three easy steps to establish a Medical Home:

  1. Choose a doctor. Call member services if you need help with this.
  2. Make an appointment with your doctor within 90 days of becoming our member. If you have a child under 18 months, make an appointment within 60 days.
  3. Talk to your doctor about health problems you are having.

Over time, you and your doctor will get to know each other better. Your own doctor has your health records and knows about your health. You will receive the best care if you can see the same doctor for your ongoing problems. If you are not sure whether you should go to the emergency department, you can call your doctor and he or she can tell you what you should do. Even if your doctor’s office is closed, your doctor will have a number that you can call 24 hours a day. You can also call our nurse advice line at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).

If you would like to change or select your PCP, login to your Member Account. You can also call member services.