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Alliance Insurance Plan Options

The Alliance offers two health plans: Medi-Cal, California’s state-health plan, and Alliance Care IHSS. Medi-Cal plans are only available to those who meet specific income requirements as set by the state. To determine if you qualify for this coverage, you can call the local department of social, health and human, or human services in your region. 

Mariposa County
Health & Human Services Agency
209-966-2000
800-266-3609

Merced County
Human Services Agency
209-385-3000
855-421-6770

Monterey County
Department of Social Services
877-410-8823

San Benito County
Health & Human Services Agency
831-636-4180

Santa Cruz County
Human Services Department
888-421-8080

To obtain Alliance Care IHSS, you will need to be registered with the Monterey County Public Authority for In-Home Supportive Services (also called the Public Authority). For more information from the Alliance, you can call 800-700-3874.

Addiction Treatment Options

Substance abuse disorder services are currently offered through each county via a fee-for-service version of Medi-Cal, not through the Alliance specifically. You should contact the local behavioral health department to learn more about your options:

Mariposa 

800-549-6741 

Merced 

888-334-0163 

Monterey  

888-258-6029 

San Benito 

888-636-4020 

Santa Cruz  

800-952-2335 

Through Alliance Care IHSS, you can go through either outpatient or inpatient treatment for substance use disorders. There is an out-of-pocket maximum of $3,000 for all members per benefit year. 

Alliance for Medical Detox

The Alliance does not offer specific coverage for medical detox. However, some inpatient and outpatient services, which may include a detox program Alliance insurance covers, could be covered with reauthorization. This is particularly likely if the detox program takes place within a hospital setting. 

 

Alliance Coverage for Residential Treatment

Alliance Care IHSS covers residential inpatient services at no charge. However, preauthorization is required. Without preauthorization, you may be responsible for up to 100% of the associated costs. 

Alliance Coverage for Outpatient Treatment

Alliance Care IHSS does cover outpatient services. There is a $10 copayment due for each service, and you may need preauthorization for some services. If you need to see a provider who is outside your network, getting a preauthorization ensures you don’t have to cover all the associated costs. 

Intensive Outpatient Programs (IOP)

Alliance Care IHSS covers intensive outpatient behavioral health services (including substance use disorder treatment) with preauthorization. 

Partial Hospitalization Programs (PHP)

Alliance Care IHSS does cover partial hospitalization programs with preauthorization. 

Outpatient Treatment

Outpatient treatment is available through Alliance Care IHSS with or without preauthorization depending on the specifics of the services. Outpatient day treatment requires preauthorization from your medical provider, as does any out-of-network service.

Alliance Rehab Coverage FAQs

Does Alliance insurance cover drug and alcohol rehab?

Yes, Alliance Care IHSS does cover drug and alcohol rehab. Medi-Cal, the Alliance’s second coverage option, has a rehab program that takes Alliance and requires you to go through Carelon Behavioral Health.

How can I verify my Alliance insurance benefits?

You may call or walk into any Alliance office to verify your insurance benefits. Call toll free at 800-700-3874. Call 800-735-2929 for the TTY Line (or dial 711). 

Does Alliance cover outpatient addiction treatment?

Finding a rehab program Alliance insurance covers is possible. With the Alliance Care IHSS plan, you can obtain coverage for outpatient addiction treatment with preauthorization. 

Does Alliance cover inpatient mental health?

Yes. Alliance Care IHSS covers inpatient mental health services at no charge and outpatient services for a $10 copay per visit. The Medi-Cal plan offers outpatient mental health service coverage through Carelon Behavioral Health at 855-765-9700 (TTY: 711).

Do treatment centers need to be in-network?

For Alliance Care IHSS coverage, you should see an in-network provider. However, if no in-network provider is available, you may be able to get out-of-network coverage with preauthorization.

How much does Alliance insurance cover?

Alliance Care IHSS provides unlimited days of coverage for inpatient or outpatient substance use disorder services through Carelon at 800-808-57986. 

How do I pay for costs not covered by Alliance insurance?

For any costs not covered by Alliance Care IHSS, you will need to cover the fees out of pocket. The copayment amount for most services is just $10 up to $3,000 annually. For prescriptions, you may pay up to $15 per prescription for each copay on specialty and non-preferred, and preferred brand drugs. Generic medications are up to $5 each at all in-network pharmacies.

How is an Alliance HMO different from a PPO?

An HMO is a health maintenance organization. HMO plans typically have their own providers and health care systems (including hospitals) that they prefer. PPOs are preferred provider organizations. PPOs give you the right to seek care from any provider in or outside of a network, while HMOs typically require care in-network. In the Alliance’s case, this care is typically through Carelon for behavioral health and substance use disorder issues.

Can you get a single-case agreement with Alliance?

Yes, however, they are typically temporary with the Alliance Care IHSS. Medi-Cal health plans also allow for single-case agreements if your medical provider requests a Continuity of Care for Providers agreement.

Sources:

https://thealliance.health/wp-content/uploads/Exhibit_U-1-SBC-IHSS-2018.pdf

https://thealliance.health/wp-content/uploads/IHSS_EOC_ENG.pdf

Single case agreements; https://file.lacounty.gov/SDSInter/ceo/agendas/1133090_HMHSFinalAgendaandMaterials11162022.pdf