Health Plan Profile
CalOptima Health
Orange County's community-based, public health plan.
Who They Are
About CalOptima
Overview
CalOptima Health is a County Organized Health System (COHS) that administers publicly funded health insurance programs for low-income children, adults, seniors, and people with disabilities in Orange County. As a COHS, CalOptima is the sole Medi-Cal Managed Care Plan in the county and is governed by a public board that includes county supervisors, providers, and community representatives. CalOptima contracts with hospitals, FQHCs, IPAs, and physician networks across Orange County and operates one of California's most established PACE programs, plus the OneCare D-SNP for dual-eligible members and the Whole-Child Model for CCS-eligible children.
Mission
"To serve member health with excellence and dignity, respecting the value and needs of each person."
As a public agency rather than an investor-owned plan, CalOptima reinvests its margins into Orange County provider capacity, member services, and CalAIM Community Supports programs.
Services
What CalOptima offers
Plan Types
Lines of business
The product lines this plan operates across Medi-Cal, Medicare, commercial, and dual-eligible populations.
Furthermore
More on CalOptima
- County Organized Health System — the sole Medi-Cal plan for Orange County.
- Operates a robust PACE and dual-eligible program portfolio.
- Administers the Whole-Child Model program for CCS-eligible children.
- Governed by a public board with county and community representation.
- Active investor in CalAIM Community Supports across Orange County.
Other Plans We Work With
Explore more California health plans
Building a growth motion with CalOptima?
CareWorx helps healthcare organizations align their patient acquisition, ECM enrollment, referral, and recruitment programs to CalOptima and other California health plans.