If you wish to file a complaint, you can contact PHC by using the link on the left side of the page for "Appeals and Grievances", or file a complaint online through Medicare.gov using this link: https://www.medicare.gov/MedicareComplaintForm/home.aspx

Looking for information on Part D? Click here to learn more about our prescription drug benefit, including how to file a grievance or appeal, look up drugs in our formulary, find network pharmacies, and more.

PartnershipAdvantage 2012 Medicare Plan Rating - Click Here (H5782 PHC_9004_PRT_004 File & Use 10/18/2011)

This website has information on the PartnershipAdvantage program.

Before moving on, please read the following important information:

• Partnership HealthPlan of California offers the PartnershipAdvantage program through a contract with the Federal Government and a contact with the California Medi-cal program.
• Benefits, provider and pharmacy network, formulary and copayments described in this website are subject to change at the beginning of each calendar year. Please contact PartnershipAdvantage for details.
• For full information on PartnershipAdvantage benefits, call our Member Services Department at the phone number listed in the section called “Contacting PartnershipAdvantage.”
• This plan is available to anyone with full-scope Medi-Cal through Partnership HealthPlan of California in Solano County, Napa County, or Yolo County and Medicare.
• Individuals must have both Part A and Part B to enroll.

What is PartnershipAdvantage?

• PartnershipAdvantage Overview
• Service Area
• Enrollment Instructions and Enrollment Form
• Quality Assurance Policies and Procedures

PartnershipAdvantage Overview

In the fall of 2006, Partnership Healthplan of California received approval from the Centers For Medicare and Medicaid Services to launch a program which coordinates a full range of Medicare and Medi-Cal services. This new program, called PartnershipAdvantage, is designed to serve low income seniors and persons with disabilities. By combining Medicare, Medi-Cal and prescription drug coverage, PartnershipAdvantage allows members to receive all of their health care benefits in one package.

All PHC members who receive full-scope Medi-Cal and are eligible to receive Medicare may enroll in PartnershipAdvantage. Services included under the program include: doctor's visits, hospitalizations, long-term care, inpatient and outpatient care, emergency medical services and prescription drug coverage. In addition, home safety assessments (for items such as shower bars), an annual physical exam, non-emergency transportation and at-home recovery services are also covered under certain conditions.

Enrollment in PartnershipAdvantage is limited to residents of Solano County, Napa County and Yolo county. To receive answers to frequently asked questions about the program, click here.

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Service Area

The counties in our service area are listed below:

Our service area for:

• Solano County residents is Solano County
• Yolo County residents is Yolo County
• Napa County residents is Napa County

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Enrollment Instructions and Enrollment Form

Most Medicare recipients who are eligible for enrollment in Partnership HealthPlan of California's Medi-Cal program who live in Solano County, Napa County or Yolo County are eligible to join PartnershipAdvantage.

PartnershipAdvantage Enrollment Form

For additional information about PartnershipAdvantage enrollment, please contact our Marketing Department. Our Marketing Department is staffed with professionals that are ready to help with any questions that you may have. They are available to assist you from 8am to 8pm 7 days a week.

The toll-free phone number is 866-249-9933. Members with hearing and/or speech impairments can call the California Relay Service (CRS) at 800-735-2929, or dial 711.

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Quality Assurance Policies and Procedures

The Partnership HealthPlan of California (PHC) Quality Monitoring and Improvement (QM/I) program provides a systematic process to monitor clinical and service aspects of health care delivery to all PHC members. It includes an organized framework to carry out objective and systematic review activities to identify opportunities to improve the quality of health care services provided, and to improve health outcomes. The program promotes consistency in application of quality assessment and improvement functions throughout the full scope of health care services while providing a mechanism to:

• ensure integration with current community health priorities, standards, and public health goals,
• identify and act on opportunities to improve care and service,
• identify and act on opportunities to improve process to ensure patient safety,
• address potential or tangible quality issues, and
• review trends that suggest variations in the process or outcomes of care.

The QM/I program provides a reliable mechanism to review, monitor, evaluate, recommend and implement actions on identified opportunities to improve care and service.

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