October 16, 2025 Newswires

A new HMO is launched, offering coordinated care for those on Medicare and Medi-Cal.

Pam MarinoMonterey County Weekly

For the first time, the region's provider of Medi-Cal, California's version of Medicaid, is launching a plan for its members who also qualify for Medicare, the federal health insurance program for people aged 65 and older or disabled adults over age 21. TotalCare, a new HMO from the Central California Alliance for Health, began enrollment on Oct. 15 for coverage that starts on Jan. 1. The enrollment period ends Dec. 7.

TotalCare is a Medicare Advantage plan, a dual-eligible special needs plan known as D-SNP, offering coordinated care for members. Someone enrolled in both programs will have access to an interdisciplinary care team that will help members navigate the health care system, says Scott Crawford, the Alliance's Medicare Program executive director.

"We see this offering as a natural part of our mission to provide high-quality care to our members," Crawford says. The goal is to improve clinical outcomes and the quality of life for members with complex needs.

The Alliance provides Medi-Cal benefits in Monterey, Santa Cruz, San Benito, Merced and Mariposa counties to more than 440,000 members, about 173,000 in Monterey County, or around half of all residents. Crawford says about 16,000 of those residents are now eligible for TotalCare. It's open to those enrolled in Medicare Parts A and B, as well as have Medi-Cal through the Alliance.

There are no plan premiums, no co-pays, other than low co-pays for some prescription drugs, Crawford says. Other benefits include vision, access to an exercise program and a flexible spending card for over-the-counter health items, among others. Members will have a single ID card and one phone number to call for assistance.

"By bringing Medicare and Medi-Cal benefits under one umbrella we can help coordinate care seamlessly and provide additional support to those who need it most," CEO Michael Schrader said in a written statement.