If you have a Medicare Advantage or HMO plan
Do you have a Medicare Advantage or HMO (health maintenance organization) plan? If so, there are three steps you need to take to become an OptumCare® member.
- Choose a health plan that gives you access to OptumCare.
- Choose an OptumCare network.
- Choose a primary care provider who is part of the OptumCare Network.
How do they all work together?
Figuring out how your health plan, medical network and doctor work together can be confusing. What’s the difference between what your health plan does and what your network does? How do they both work with your doctor? We’ve created a graphic to help make it more clear.
Start with your health plan
If you want to switch to a doctor who is part of OptumCare, start by calling your health plan. Many Medicare Advantage and HMO plans have contracts with OptumCare. Ask if your plan allows you to choose an OptumCare network or doctor.
Choose your network and doctor
In some states, OptumCare might be the only network in your plan, so all you have to do is pick a primary care doctor in the network. If you have a choice of different networks, select OptumCare as your network and choose an OptumCare doctor.
In California, networks that are part of OptumCare include Monarch, AppleCare and Primary Care Associates. Call the office of the doctor you want to see and ask which network the doctor is in. Then tell your health plan that is the network and doctor you want.
When can I join?
The open enrollment period is a time when people who are eligible for Medicare or an HMO plan can:
- Enroll in a new Medicare Advantage (MA) plan.
- Switch from original Medicare to an MA plan.
Your new plan will usually go into effect on January 1 of the next year.
Find out more about your Medicare Advantage options.
Can I join at other times of the year?
You might be able to join OptumCare at other times of the year if:
- You’re already a member of a health plan that partners with OptumCare.
- You enroll in a new health plan that partners with OptumCare.
- You qualify for both Medicare Parts A and B, including if you also have Medicaid (Medi-Cal in CA).
For more information on the health plans accepted by OptumCare providers, call us today at:
For more information about Medicare eligibility and Medicare Advantage plan enrollment, go to the CMS website at www.medicare.gov or call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week.