Alternative Access Standards
The Department of Health Care Services (DHCS) gives health plan guidelines on how far and how long it should take for members to access health care services. Time and distance standards are:
| Provider Type | Time and Distance Standard |
|---|---|
| Primary Care (Adult and Pediatric) | 10 miles or 30 minutes from a member’s residence |
|
Specialty Care (Adult and Pediatric) *including OB/GYN |
15 miles or 30 minutes from a member’s residence |
| Hospital | 15 miles or 30 minutes from a member’s residence |
The list below shows the approved alternative time and distance standards from CalOptima Health based on zip code and the type of specialty provider. If you live in one the zip codes listed below and need care from a specialty provider, please call 1-800-611-0111. We have staff who speak your language. They will help you find a provider closest to you. If a provider within the regular time and distance standards is not available to you, you can request transportation to a provider farther away at no cost to you. Family Choice Health Services can also help connect you with a closer provider, even if they are not in Family Choice Health Services provider network.
If you speak a language other than English, free language assistance services are available.
Alternative Access Standard
| Zip Code | City | Provider Type | Population Served | Miles | Minutes |
|---|---|---|---|---|---|
| 00001 | City 1 | Hematology | Adult | 20 | 35 |
| 00002 | City 2 | Ophthalmology | Pediatric | 20 | 35 |
| 00003 | City 3 | Dermatology | Adult and Pediatric | 20 | 35 |
Telehealth
| Provider Type |
|---|
| Hematology |
| Ophthalmology |
| Dermatology |