FAQs | Prospect Medical Systems

Flu Vaccine- Get your flu vaccine!

IMPORTANT: It’s almost time to renew your Medi-Cal coverage. You will get a letter in the mail that tells you if your Medi-Cal was renewed automatically by the county or if your county needs more information. If you receive a renewal packet or a notice asking for more information, please visit KeepMediCalCoverage.org for the next steps.

All Disney Cast Members and employees, along with their insured family members, who sign up in our Value Added health plan have access to a Red Carpet Usher as your personal healthcare guide. Your Red Carpet Usher will help you navigate your insurance plan and select a primary care provider (PCP), answer any questions and provide bilingual assistance as needed.

If you are a Disney employee or Cast Member and want to sign up or learn more, call (844) 757-7999 weekdays between the hours of 8 a.m.-5 p.m. or email us.

Prospect contracts with Cigna to provide primary care providers in our Value Added health plan. The primary care provider (PCP) you select works with you and Prospect to help coordinate your healthcare services.

We provide your PCP support services, such as care management, referrals for specialists and outpatient services, lab tests, medical supply requests, customer service and education services. This gives your providers the freedom to do what they do best—take care of you.

Unlike a closed health plan that can limit where you get care and services, our Value Added plan is an open network that offers more choice. That means you can choose a physician, hospital or other services where you live or work. Saving money for comparable quality and more choices is a smart move to take care of your healthcare needs.

Prospect’s extensive primary care provider network means that you can select a PCP close to your home or work. Here are steps you can take in selecting your primary care provider.

  • You can select your provider by name, geographic location or specialty. Many of our providers have special training and skills, as well as speak multiple languages
  • You can call the provider to obtain provider identification number to submit to Cigna to get you on board with Prospect Medical Group

Referrals for specialties that are in our Direct Referral program are authorized upon submission. For other specialties where a referral is needed, your PCP will send the referral request(s) to Prospect’s Utilization Management staff for approval.

Here’s how it works:

  • Most referrals or requests are received back within five business days and many can be approved the same day.
  • If you have a question about a referral or the status of a referral request/s, contact your PCP’s office, or call a Red Carpet Usher at (844) 757-7999 or email us.

Your PCP may request a STAT/URGENT referral request(s) by contacting our Prospect’s Utilization Management team to discuss the medical urgency of the request(s). STAT/URGENT referral requests are processed within 24-48 hours. If you have any questions about this process, contact a Red Carpet Usher at (844) 757-7999.

Our referral network has been established to provide you the broadest range of quality specialists and facilities that best meet your needs. If you’re not satisfied with the specialists or facility you’ve been referred to, please contact a Red Carpet Usher at (844) 757-7999.

We’re here to give you the support you need and help you make the best choices for your care.

For prescriptions and refills, ask your doctor to complete a prescription slip. Take your doctor’s prescription slip to a Cigna-affiliated pharmacy.

If you are experiencing an emergency or life-threatening condition, please call 911 or go to the nearest emergency room.

Prospect Medical Group provides urgent care services for non-life-threatening emergencies that occur outside of normal doctor office hours. Urgent medical conditions are ones that are not considered emergencies, but still require care within 24 hours. Some examples include, sore throat or ear aches, fever, minor injuries or lacerations, minor fractures, allergic reactions and/or sports injuries.

You can also call Cigna at (800) 577-7498 to access its 24-hour nurse consultation lines that can advise you whether to go to an urgent care center or wait until your doctor’s office reopens.

If you have an emergency call 911 or go to the nearest emergency room. The need for emergency care is defined as an illness or injury that a reasonable layperson feels puts him or her in danger or could be seriously harmed. These include broken bones, severe chest pain, severe burns, fainting, drug overdose, severe bleeding and psychiatric emergency conditions.

If you have questions regarding your bill statement, our Red Carpet Ushers are available to assist you with questions related to your account. You can contact a Red Carpet Usher by calling (844) 757-7999 between the hours of 8 a.m.-5 p.m., Monday through Friday, excluding holidays, or email us.

A co-payment is what you pay your provider for services received and goes directly to the provider. A co-insurance is a percentage of billed charges. The co-payment and co-insurance amount is a set by your health plan.

All members of Prospect Medical have the right to file a grievance or appeal at any time. Please visit our Grievance and Appeals page for more information or contact your Red Carpet Usher for more direction at (844) 757-7999.

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(844) 757-7999