Members
Why Choose Central Valley Health Plan (“CVHP”)
Central Valley Health Plan offers its members Medicare Advantage plans through select, trusted insurance partners. Central Valley Health Plan provides an enhanced level of personalized health care with an emphasis on prevention, access and quality of life. CVHP focuses on all of its members and continuously assesses each member’s healthcare needs, not just when a member needs specialist care or hospitalization. We work with each member to ensure that individual health goals are met and provide resources to meet those goals.
Selecting Central Valley Health Plan
- Members select Central Valley Health Plan during the Medicare Annual Enrollment Period.
- Members choose a health plan that includes CVHP from one of our select insurance companies, currently Humana Medicare Advantage Gold Plus.
- Members then select a primary care physician (PCP) from Central Valley Medical Providers, or Santé Physicians.
- Members then select Central Valley Medical Providers, or Santé Physicians, as their specialty network.
Care Management
Central Valley Health Plan offers comprehensive medical management services to its members through Complex Case Management, Disease Management and Case Management programs. Enrollment is these programs is initiated by a member’s care team including the Primary Care Physician, attending specialist, or hospitalist for members receiving inpatient care. For more information enrollment criteria or program details, contact CVHP at (833) 882-2847.
Customer Support
Humana
Central Valley Health Plan partners with Humana to offer its Medicare Advantage Gold Plus HMO plans.
Contact: 1-800-457-4708 (TTY: 711), daily, 8 a.m. - 8 p.m.
Central Valley Medical Providers
Contact: (559) 581-9004
Santé Physicians
Contact: (559) 228-5400 or (800) 652-2900
Grievance and Appeals
If you are dissatisfied with any aspect of your healthcare plan, Customer Care, your provider or treatment facility, you can submit a grievance at any time through Humana Customer Support services. Grievances do not include claims or service denials, as those are classified as appeals. The link below provides complete information on filing a grievance or appeal for a claim or service denial.
Instructions for members to file a grievance and appeal are available at the link below.
https://www.humana.com/member/