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Member Services Phone Number 888.301.1228

Resources

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Beacon Health Options

Mental Health

Beginning January 1, 2014, your Medi-Cal coverage will now include some Mental Health care benefits. Please refer to your Evidence of Coverage (EOC) for more information regarding these new benefits.

Gold Coast Health Plan (GCHP) will provide these services through Beacon Health Options.  If you need mental health services, you can call Beacon Health Options at 1-855-765-9702, TTY 1-800-735-2929. If your doctor works with GCHP, you can keep your doctor.

If your doctor doesn’t work with GCHP, and you want to keep that doctor, you can call Member Services at 1-888-301-1228, TTY 1-888-310-7347 for help. We will let you keep the doctor for up to 12 months, if the doctor agrees to work with us.

Benefit Information

Apply for Medi-Cal and other social service programs at www.mybenefitscalwin.org.

California Children’s Services

California Children’s Services (CCS) and Gold Coast Health Plan (GCHP) work together for the benefit of children and young adults residing in Ventura County. CCS provides services for children with physical disabilities or conditions that are costly, chronic or catastrophic.

If you have questions about CCS eligibility, GCHP Care Managers may be able to assist you.

Click here to access the CCS website where you can access information about eligibility, benefits, how to apply and all CCS programs.

The CCS office in Ventura County is located at:
2240 East Gonzales Road, Suite 260
Oxnard, CA 93036
Phone: (805) 981-5281
Fax: (805) 658-4580

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Care Management

Care Management is a service that is available to you as a Gold Coast Health Plan member. Your doctor can ask us to assist you, or you can contact us yourself for a health-related concern.

GCHP Care Managers are Registered Nurses and Social Workers and are ready to work with you should you require assistance with:

  • Understanding and managing your benefits
  • Communicating with your doctors
  • Establishing a Medical Home
  • Learning about Community Resources that may be available to you
  • Setting goals and making plans for improving your health
  • A new diagnosis that is causing you concern
  • Learning about your condition
  • Problems with your pregnancy
  • Organ transplant questions
  • Managing multiple medications

To reach the GCHP Care Management Department, please call 805-437-5650 or email: caremanagement@goldchp.org. If emailing, please include your telephone call back number and GCHP Identification Number for a prompt response. Deaf and hard of hearing members can call our TYY line at 1-888-310-7347.

Community-Based Adult Services Program (CBAS)

The Community-Based Adult Services Program (CBAS) transitions from a fee-for-service program to a Medi-Cal managed care benefit, on October 1, 2012. CBAS replaces the state’s Adult Day Health Care (ADHC) program and will be managed by Gold Coast Health Plan. Go here to learn more about CBAS.

Consumer Advisory Committee

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Contracted Hospitals

Los Robles Hospital and Medical Center
215 W. Janss Road
Thousand Oaks, CA 91360
805.497.2727
www.losrobleshospital.com

Ojai Valley Community Hospital (CMH)
1306 Maricopa Highway
Ojai, CA 93023
805.646.1401
www.cmhshealth.org

Santa Paula Hospital (VCMC)
825 N. 10th St.
Santa Paula, CA 93060
805.933.8600
www.vchca.org/hospitals/santa-paula-hospital

Simi Valley Hospital and Health Care Services
2975 N. Sycamore Drive
Simi Valley, CA 93065
805.955.6000
www.simivalleyhospital.com

St. John's Pleasant Valley Hospital
2309 Antonio Ave.
Camarillo, CA 93010
805.389.5800
www.stjohnshealth.org

St. John's Regional Medical Center
1600 N. Rose Ave.
Oxnard, CA 93030
805.988.2500
www.stjohnshealth.org

Ventura County Medical Center (VCMC)
3291 Loma Vista Road
Ventura, CA 93003
805.652.6000
www.vchca.org/hospitals/ventura-county-medical-center

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Denti-Cal Program

Dental Services for Medi-Cal beneficiaries under 21 years of age are currently provided as a carved out benefit through the Denti-Cal Program. Click here to search for dentists in your  local area and throughout the State if you are a Denti-Cal beneficiary or contact the Denti-Cal Service Center for additional help at 1-800-322-6384.

Starting May 1, 2014, certain adult dental benefits will be restored in accordance with Assembly Bill 82. Note: these services are not a benefit for beneficiaries 21 years of age and over until May 1, 2014. Click here for a full description of restored services and procedures from Section 5 of the “Manual of Criteria and Schedule of Maximum Allowances.”

Disease Management

Gold Coast Health Plan (GCHP) cares about you and your family! That’s why the Plan offers Disease Management Programs for Asthma, Diabetes and Pre-Diabetes. The programs are for members and their families with asthma, diabetes and pre-diabetes. The programs are a free GCHP benefit. They offer resources and educational materials in both English and Spanish.

The Disease Management Program for asthma or diabetes can connect you with a nurse coach to:

  • Answer your specific questions.
  • Help you create a plan of action for you and your family.

GCHP can connect you with English and Spanish classes in Ventura County near your home or work. The classes can help you learn ways to stay healthy and be active. Classes include information about managing many chronic conditions.

The classes can also teach you ways to keep your family healthier and more active.

Partnering with GCHP is easy. All you need to do is call 1-805-437-5588/TTY 1-888-310-7347 and tell us how we can help you and the best way to reach you. You can stop the program at any time.

Click here to learn more.

Grievance & Appeals (G&A)

Gold Coast Health Plan’s grievance & appeals (G&A) process provides a mechanism for members to report complaints regarding their health care benefits. Please use the Member Grievance & Appeals Form to submit your complaint.

Submit your completed forms to:

Gold Coast Health Plan
Attn: Member Grievance & Appeals
P.O. Box 9176
Oxnard, CA 93031

Human Services Agency

The County of Ventura Human Services Agency (HSA) provides a broad array of services that include the protection of children and vulnerable adults and support for those needing assistance with food, housing, health care and employment. Click here to access the Medi-Cal site.

Member Rewards

Gold Coast Health Plan (GCHP) values the health of its members. To encourage healthy behavior, GCHP is offering rewards to members who complete these preventive care exams:

  • Postpartum Care Exam
    New mothers who complete a postpartum care exam within 3 to 8 weeks after delivery can receive a large pack of diapers.
    Click here for the form to apply for the member reward. (Updated July 25, 2016)
  • Annual Well-Child Exam (3 to 6 Year Old Children)

    GCHP wants to give your child a $15.00 gift card for getting a well-child check-up in 2017. The child must have a well-child exam by December 31, 2017.
    Click here to download the form.
  • Annual Well-Child Exam (7 to 11 Year Old Children)
    GCHP wants to give your child a $15.00 gift card for getting a well-child check-up in 2017. The child must have a well-child exam by April 30, 2017.
    Click here to download the form.

Staying Healthy Assessment Tool

You can download the Staying Healthy Assessment Tool in English or Spanish.

Tri-Counties Regional Center (TCRC)

Tri-Counties Regional Center helps people with developmental disabilities of any age with services and support for living, working, learning and recreating in our community.

If you are receiving TCRC services and need help with getting care for a medical problem, talk to your primary care doctor (PCP).  Your PCP can ask Gold Coast Health Plan’s Care Management nurses to work with TCRC and the PCP to help get your care needs met.

TCRC offices in Ventura County:
Oxnard
2401 East Gonzales Road, Suite 100
Oxnard, CA 93036
(805) 485-3177 or (800) 664-3177
FAX (805) 988-9521
Simi Valley
1900 E. Los Angeles Ave. Second Floor
Simi Valley, CA 93065
(805) 522-8030 or (800) 517-2524
FAX (805) 522-8142

Click here to access the Tri-Counties Regional Center website.

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