AllCare : FAQs

What is an IPA?
IPA stands for Independent Physician Association. An IPA is comprised of independent physicians that have joined together to provide a comprehensive network of multiple specialties, developed specifically for your health plan.

What is an HMO?
HMO stands for Health Maintenance Organization. A Health Maintenance Organization is a health care system designed to provide comprehensive medical services for members enrolled in a particular geographic region.

How do I choose AllCare IPA for my Medical Group?
Upon joining one of AllCare's health plans, each member has the option of choosing a medical group. Issues to consider when choosing a medical group include:

Does the medical group accept your health plan? AllCare IPA contracts with the most respected HMOs in California. Check our Online Health Plan List.
Is your family's physician or physicians part of the medical group? AllCare IPA has an extensive network of primary care physicians and specialists. Check our Online Physician Directory for a list of Primary Care Physicians.
What hospitals are affiliated with AllCare? AllCare IPA offers hospitals in Stanislaus and Merced Counties, see our Online Hospitals list. For special services, AllCare IPA offers some of the finest tertiary hospitals in Northern California.

How do I enroll with AllCare IPA?
Becoming a member of AllCare IPA is easy. Just follow the steps below.

Steps if you are new to a health plan:

Choose an AllCare Primary Care Physician.

This can be accomplished by reviewing your health plan directory under AllCare IPA, by accessing the Online Physician Directory or by contacting AllCare’s Customer Service Department at (209) 550-5200 for assistance.

The Online Physician Directory “detail” section will show you the office hours, languages and if the physician is accepting new patients.
After selecting an AllCare Primary Care Physician, complete the "Sign Up Now" form. You may e-mail or print this form for your Employer / Human Resource Representative. You may also call your health plan directly with this information.

Steps if you are already a member of the health plan, and you wish to stay with your current Primary Care Physician and switch your medical group to AllCare:

Find your current Primary Care Physician by using our Online Physician Directory. You may also select a new Primary Care Physician in AllCare using this same option.
Click on the "detail" section of your Primary Care Physician and fill in your name above the "Sign Up Now" icon.
Complete the "Sign Up Now" form. You may e-mail or print this form for your Employer / Human Resource Representative. You may also call your health plan directly with this information.

What is a Primary Care Physician?
Your health plan requires each member to select a Primary Care Physician. You can choose one from our Online Physician Directory or one will be assigned to you by the health plan. Your Primary Care Physician is responsible for coordinating, arranging, and delivering all necessary medical care for you including specialist care and tests.

Will my child get his or her own Primary Care Physician?
Yes. AllCare encourages you to choose a pediatrician or family practice physician, who will develop a close relationship with your child and their health care needs.

Must all family members select the same Primary Care Physician?
No, each family member can select his/her own Primary Care Physician, or the same Primary Care Physician.

What is the difference between a Family or General Practice Physician and an Internal Medicine Physician?
A Family Physician treats adults and children for general medical conditions. Family Physicians are trained in dealing with family issues and relationships, and may provide general gynecology services.

An Internist treats adults 18 and above and specializes in the diagnosis and treatment of disease.

Should my teenager see a pediatrician?
Pediatricians specialize in the prevention, diagnosis and treatment of diseases of children from birth to adolescence. Most pediatricians treat children up to the age of 18.

How do I move from another medical group to AllCare?
Contact your health plan through the customer service phone number listed on the reverse of your HMO insurance card. Let them know that you wish to change to AllCare IPA. The health plan will obtain your information, make the change, and notify AllCare.

What if I need care when my physician’s office is closed?
For any unforeseen injury or illness for which a delay in treatment would result in a permanent physical impairment or loss of life, call 911 or go directly to the nearest emergency room. Otherwise, call your physician for advice and direction. If your physician is not on duty, an on-call physician is available to help.

Which HMO health plans does AllCare IPA offer?
Please use our convenient Online Health Plan List, to view our contracted health plans.

Which hospitals are part of AllCare’s network?
Please use our convenient Online Hospital List, to view our contracted hospitals in Merced County and Stanislaus County.

In an emergency to which hospital do I go?
For any life-threatening emergency, call 911 or go directly to the nearest hospital. Emergencies do not require prior medical review. Please inform your Primary Care Physician and health plan within 48 hours of your visit. If you use the emergency room for what is clearly a non-emergency situation, it is possible you will be billed by the Hospital for these services.

Does AllCare offer any financial rewards or any other incentives to withhold services?
No. AllCare IPA does not offer financial rewards or other incentives to withhold or lower the usage of services.

Who makes the decision to authorize medical services?
When your physician requests services, the request is reviewed by licensed AllCare personnel including physicians, who are trained in the principles of utilization management. The decisions are based on the most recent clinical studies and evidence-based treatment protocols. Written criteria is available to the requesting physician, our members, and the public by calling or writing AllCare.