If you think you have been exposed to COVID-19 or have symptoms, call your primary care doctor. Your doctor may refer you to a COVID-19 test site. There is no cost to members for medically-needed screening, testing, and treatment for Coronavirus
Commonly asked questions – Questions or comments about Health Plan of San Joaquin / Mountain Valley Health Plan (“Health Plan”)? Here are some of the most frequently asked questions. If you still can’t find the answer to your question, you can complete the Contact Us form below. We will refer your message to the appropriate person or department within our organization.
Here are some answers to the most commonly asked questions:
I am a current Health Plan member
ID Card Request
I’m a new member, when will I get my ID card?
Your card will be mailed to the address on file within 7 business days after becoming a member of Health Plan.
I’m an existing member and need a replacement ID card.
Please create or log into your member account by visiting the Members page or contact Customer Service at our Toll Free number 1-888-936-PLAN (7526) or 1-209-942-6320.
How can I change my Primary Care Physician (PCP)?
Please create or log into your member account by visiting the Members page or contact Customer Service at our Toll Free number 1-888-936-PLAN (7526) or 1-209-942-6320.
I want to update/change my address
If you reside in San Joaquin County, contact your case worker or Human Services Agency (HSA) at1-209-468-1000.
If you reside in Stanislaus County, contact your case worker or Community Service Agency (CSA) at their Toll Free number 1-877-652-0734 or 1-209-558-2777.
Do I have Behavioral Health benefits?
These services are coordinated by Health Plan. Please call 1-888-581-PLAN (7526). Click here to learn more.
Do I have Vision benefits?
These services are administered by Vision Services Plan (VSP), please contact them at 1-888-321-7526. Click here to visit their website
Do I have Dental benefits?
Your dental benefits are covered by Smile California, please contact them at 1-800-322-6384. Please be sure to present your Medi-Cal card.
Assistance with Medi-Cal annual renewals
Please contact our Enrollment Team at our Toll Free number 1-888-896-PLAN (7526) or 1-209-942-6328.
For other benefit questions or other inquiries
Please contact Customer Service at our Toll Free number 1-888-936-PLAN (7526) or 1-209-942-6320, or complete the Contact Us form below:
I am a provider
Utilization Management/Medical Director
For authorization related questions, please contact Customer Service at 1-209-942-6320 or Provider Services at 1-209-942-6340 and you will be directed to the appropriate UM staff member. For physician peer to peer discussion, please call 1-209-942-6353. To send a fax to the UM Department, please use 1-209-942-6302 for the Prior Authorization Team and use 1-209-762-4702 for the Inpatient Team. Health Plan appoints a physician as a full-time medical director pursuant to 22 CCR section 53857. To reach Dr. Lakshmi Dhanvanthari, please login to the provider portal for contact information.
Claims/Authorization Status
Please log into our Provider Portal (DRE). If you are not currently a provider portal (DRE) user, please click here and select Sign Up for more information.
Password Reset
If you are locked out of the Provider Portal (DRE), please contact Provider Services at 1-209-942-6340.
Eligibility
For eligibility, please call our automated system at 1-209-942-6303 or log into our Provider Portal (DRE).
Forms
Forms (i.e. Authorization, Referral, etc.) can be found in Section 3 – Additional Resources of the Provider Manual under Forms & Documents.
Health Plan has an Enrollment Team dedicated to providing FREE Medi-Cal Application assistance.
Enrollment
If you are interested in becoming a Health Plan member, please contact our Enrollment Team at our Toll Free number 1-888-896-PLAN (7526) or 1-209-942-6328, or fill out and submit the interest form, and you will receive a response by the end of our next business day.
Benefits
What are the covered benefits?
Please review our Evidence of Coverage located under Member Tools or contact Customer Service at our Toll Free number 1-888-936-PLAN (7526) or 1-209-942-6320.
Interest Form:
Please fill out this form and a representative from Health Plan will be in touch with you soon. Our callback hours are from 8:00 a.m. - 5:00 p.m.
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COVID-19
Advice Nurse Line
HealthReach 24/7 advice nurse line for Health Plan members.
Self-Help and Customer Service
Schedule an over the phone appointment and get help.
Online Access
Access your Health Plan information online, open an account now!
Applying for Medi-Cal
Do you need health coverage now? We can help you get started.
Covid-19 Member Information
Health Plan members have access to several benefits to help you through COVID-19. We've highlighted key services and COVID-19-related topics that may be useful to you during this difficult time.
Covid-19 Community Resources
A List of all community resources available in the Stanislaus and San Joaquin County Areas
General Telephone Numbers
Contact us today! Customer Service Representatives are available to assist you Monday – Friday from 8:00 a.m. – 5:00 p.m.
Toll Free 1-888-936-PLAN (7526)
Provider Services 1-209-942-6340
Hearing Impaired TTY 711
Automated Eligibility System 1-209-942-6303
General Fax 1-209-942-6305
Authorizations Fax 1-209-942-6302
Locations
Health Plan is part of the Two-Plan model and serves as the local initiative in Alpine, El Dorado, San Joaquin, and Stanislaus counties.
San Joaquin
HPSJ/MVHP Headquarters
7751 South Manthey Road
French Camp, CA 95231
Commonly asked questions – Questions or comments about Health Plan of San Joaquin / Mountain Valley Health Plan (“Health Plan”)? Here are some of the most frequently asked questions. If you still can’t find the answer to your question, you can complete the Contact Us form below. We will refer your message to the appropriate person or department within our organization.