FAQ Providers

What is Community Care Health Plan’s service area?
Community Care Health Plan is Fresno’s only locally based, commercial health plan. We serve members based in Fresno and adjoining counties. See a list of all ZIP CODES included in Community Care Health Plan’s service area.
 
Which services are covered under Community Care Health Plan?
Community Care Health Plan is a comprehensive health care service plan that offers a full range of medical care.  Covered services always include coverage for doctor office visits, hospital stays, surgery, outpatient procedures, preventive services (periodic immunizations, physical exams, and routine screenings) and much more. These services are provided at varying levels of copayments and/or coinsurance. Coverage varies depending on the benefit plan you’re enrolled in. Contact member services if you have questions about which services are covered under your plan and your cost share.
 
How do enrollees of Community Care Health Plan select a primary care physician?
Enrollees will have the opportunity to choose a primary care physician (PCP). If a participant does not choose a PCP at the time of enrollment Community Care Health Plan will assign them one. If at any time the enrollee would like to change their PCP they may call Community Care Health Plan for assistance at (855) 343-2247.
 
How does my office verify eligibility, benefit & copays?
Please contact Community Care Health Plan at (855) 343-2247 to verify eligibility, benefits and copayment information.