Who Gives Me Health Care?
In most cases, you need to get care within HWLA’s network. That is not the case if you need emergency care. You can learn more about this in the “Emergency care: How do I get care in an emergency?” section of this handbook.
Your Medical Home Doctor Gives You Most Of Your Care
Your medical home is responsible for making sure you get the health care benefits you need and should receive from HWLA.
How To Change Your Medical Home
You may have picked your medical home or it was chosen for you based on how close you live to the medical home. It is best to stay with the same medical home. Your medical home gets to know your health history and health needs. If you can’t stay with the same medical home, you can choose a new one from the HWLA network shown in the Provider Directory mailed to you with this handbook.
You can change your medical home once a month and it will become your medical home on the first day of the next month, as long as the chosen medical home is still able to take more enrollees. To change your medical home, call Member Services. If your medical home of choice is full, you will have to choose another medical home.
The medical home you choose may not agree to treat you and may ask HWLA to make a change. This can happen if:
- You are disruptive or disrespectful to your doctor or your medical home’s office staff.
- You do not follow your doctor’s treatment plan.
- The service or care you need is not within the doctor’s scope of care.
How To Get Care From A Specialist
Your medical home doctor is the doctor who makes sure you get the care you need when you need it. Sometimes your medical home doctor will send you to a specialist. A “specialist” is a doctor who is an expert in a certain kind of health care. These specialists are within your medical home’s network. If you need care from a specialist, your doctor and HWLA must approve these services before you receive them.
Care Outside Of HWLA Program Network
As a member of HWLA, your service area is Los Angeles County. For non-emergency care, all health care services are provided in Los Angeles County. Non-emergency care outside of L.A. County is not covered.
Within LA County, you need to get most care within HWLA’s network. However, you can always get emergency care at any hospital emergency department. Tell them you are a HWLA member or show them your ID card.
If you get non-emergency care from a doctor or other provider that is not a part of HWLA’s network or outside of Los Angeles County, you may be billed by the provider and you may have to pay.