The People's Guide

35th Edition 2013-2014

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The People's Guide 2013-2014 52 Health benefits at no cost to you include: • Excellent quality medical care • Many clinics and health centers to choose from as your medical home • ID Card to let people know you are a member of HWLA • Health education services to help you live healthy and prevent disease • Toll free member information line 24 hours a day, 7 days a week, even on holidays • Preventive and primary care services within 30 working days, as well as care management services, hospital care, emergency room visits, and mental health services For more information, please call Healthy Way LA Member Services at 1-877-333- HWLA or 1-877-333-4952. If you don't qualify for HWLA because of your age or immigration status you can apply for Healthy Way LA Unmatched at a Community Partner clinic for clinic care. At County clinics and hospitals you will need ATP. Sometime in 2014 HWLA will become part of Medi-Cal. When that happens HWLA members will have to join a Medi- Cal health plan and will be able to choose from a wider network of medical providers. ATP If you don't qualify for HWLA and you need care, at a county clinic, it's best to use ATP. ATP pays for all clinic and hospital care, including medicines, tests and lab work. You must apply annually. If you don't qualify for free ATP you might qualify for low-cost ATP. The screener will figure out what you must pay, if anything, for each visit. The application process is only one page asking about family size and income. . However, you don't need to bring docu- ments to show proof of the information; you just sign a form stating that what you say is true. Later, random patients will be asked to provide documents to prove income.. Be sure to save your income documents for at least one year after you apply. ATP is good for one year, and at the end of one year you will have to apply again. To apply for ATP, you must make an ap- pointment for a financial screening at a county hospital or clinic that has an ATP worker. Sometimes you will be able to be seen the same day, but you may have to wait. You do not have to wait for your financial screening to get care. If you ap- pear to qualify for Medi-Cal, you will be asked to apply and either get a decision that you are not eligible or are only eligible for restricted benefits before an ATP ap- plication will be taken. Be very firm about your right to apply for free care and be sure to ask for ATPor HWLA at the county clinics or the Com- munity Partner clinics. If it is your first visit to a county hospital or clinic, they should give you a written notice regarding available plans, including HWLA and ATP, to reduce the cost of your medical care. If you do not receive this notice at your first visit, ask for one. If the worker or the clinic screener you see tells you that you do not qualify for HWLA,, ATP or free care and you do not agree, ask to meet with the worker's super- visor within 10 working days. If you were found ineligible before, you may reapply. If you are unable to keep your screening appointment, call the worker immediately or you may be billed for the full cost of any treatment you have already received. Even if you do not qualify for HWLA or ATP, you still have a chance to pay a low- cost fee for the outpatient services within seven days. 3. Pre-Payment Plan The Pre-Payment Plan is only available at County clinics and hospitals. It cov- ers cost of care but often does not cover your prescriptions (however, you can get emergency prescriptions, public health medicines, and medicines provided in the clinic at no cost). You do not have to prove your income, family size, or resources if you pay the fol- lowing standard fees within seven days of treatment. But you do need to show proof that you live in L.A. County. If you do not pay these fees, you will be billed for the much higher full amount cost of care: • $80 at all County Comprehensive Care Centers, County Hospital Outpatient Clinics, and Public Health Centers; for prenatal visits, the first seven cost $60 and remaining visits are free • $80 at County Comprehensive Health Center Urgent Care Centers • $140 at County Hospital Emergency Rooms • $500at Hospital Outpatient Surgery Clinics Most Community Partner clinics also of- fer a sliding scale for patients who don't qualify for free care. 4. What Else Should I Know? If you have any questions about your care, need referrals, or have a complaint, call the County Health line: (800) 427-8700. You can also call the Health Consumer Hotline:(800) 896-3203. • If you receive free or low cost medical care, your medicines are free. • Non-citizens with restricted Medi-Cal coverage who live in L.A. County can apply for ATP or HWLA Unmatched to cover non-emergency care. • Before using ATP, you must use any other medical benefits you have such as private insurance, or outpatient Medicare. ATP will cover your deduct- ible for private insurance, but will not cover inpatient Medicare deductibles and Medi-Cal "Share of Cost". • Foreign visitors with a valid visa can receive emergency services at County hospitals and clinics, but are not entitled to ATP, Pre-Pay or HWLA for medical services. They may apply for the County's Out of County Discount Payment Plan. 5.Cancer Detection Program: Every Woman Counts (EWC) EWC provides free mammograms for women age 40 and over and free pap smears for women over age 21. Your family income must be below 200% of poverty. The services are provided at doctors' of- fices, clinics and hospitals all over Los Angeles County. Call the Cancer Detection Program at (800) 511-2300. MENTAL HEALTH If you believe you need mental health services, you should call the Local Mental Health Plan's 24-hour "Access Center," at (800) 854-7771, which can screen and evaluate your request for mental health services and can refer you to a mental health provider. County Mental Health authorizes and can provide treatment including Medi-Cal "specialty mental health services" for all Medi-Cal recipients. County Mental Health also authorizes and provides Medi-Cal recipients with other services to help them live and function Health Care

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