FAQs for Patients

MSN eligibility is, at a maximum, for one calendar year. Eligibility will terminate on the 31st of December every year for all members. Individuals wishing to renew their MSN eligibility must have an urgent or emergent medical condition, meet all other eligibility requirements, AND apply again in January of the next calendar year.

All applicants are sent a letter called a “Notice of Action” or “NOA”. This letter informs the applicant of their eligibility result: either an approval or a denial.

The approval NOA also has a tear-out member ID card for convenience. It is important to present either the NOA or the card prior to receipt of service.

The application is reviewed by the MSN Eligibility Technician.  This process takes approximately four weeks from the date of application.  Questions about the status of an application should be referred to the MSN Eligibility Information Line at (714) 347-0389.

The MSN Program covers necessary medical services to protect life, limb and prevent significant disability. MSN provides for services that are medically necessary to protect life, prevent significant disability, or prevent the serious deterioration of health. The Medical Safety Net Program does not provide comprehensive health coverage, primary, or preventive care.

A list of covered and non-covered services is available in the MSN Patient Handbook.

Yes. The MSN Program has co-pays for all medical services including hospital, clinic, lab, X-rays, and prescriptions. The co-payment amounts are the sole financial responsibility of the MSN member and, in most circumstances, must be paid when services are rendered.

A listing of co-pays for medical services and examples of commonly prescribed medications and their co-payment amounts are available in the MSN Patient Handbook.

Applications are taken by trained individuals at the MSN Contracted Hospitals listed in the MSN Patient Handbook. You must have an urgent or emergent medical condition to apply for the program. Additionally, you must provide current proof of the following:

• Proof of Identification
• Proof of Orange County residency
• Proof of Income and Property
• Proof of U.S. Citizenship or Lawful U.S. Residency

Applications without these documents are incomplete. Incomplete applications will be denied.

Members may change their assigned clinic once during their eligibility period. Please call the MSN General Information Line at 714-834-6248 to change your assigned clinic.

Note: Services received from any clinic other than your assigned one will result in a denial of payment and will become the financial responsibility of the member.

No. The MSN Program does not provide primary or preventive care. The MSN Program provides medically necessary follow-up care at the member’s chosen clinic.

MSN members can choose their assigned clinic at the time of their application.

Urgent Care Centers are available for medical conditions that are not of a serious nature but require immediate treatment. A list of these facilities is available in the MSN Patient Handbook.

Life or limb threatening conditions should be evaluated in the Emergency Department (ED). Always access the closest ED in these situations.

Requests for physician specialty services must be coordinated through the member's assigned clinic, and are approved by the MSN Care Coordination Unit. Please refer to the MSN Patient Handbook for additional information on this process.

Prescriptions must be filled at participating MedImpact pharmacies. Ask your local pharmacist if the pharmacy is a participant. A list of participating pharmacies is available on the MSN website at www.ochealthinfo.com.

Under the MSN Program all prescriptions, including generic medications, have a co-payment. Co-payments are the sole financial responsibility of the member.

Your assigned clinic will refer you to a lab or diagnostic imaging center. MSN members can use any lab they like so long as it is a participating provider. Please contact your preferred lab or imaging center and ask if they accept MSN. You may also have these procedures done at any of our MSN Network Hospitals. These are listed in the MSN Patient Handbook.

Note: All diagnostic services must have a written order from a physician, nurse practitioner or physician assistant. Diagnostic imaging may require prior-authorization.

Providers of service will bill you if they are not aware of the member's MSN eligibility or if your eligibility is pending approval of your application. It is the member's responsibility to inform all providers of their MSN eligibility status as soon as they receive their NOA letter from the County. It is a good idea to photocopy the NOA letter, and send or give a copy to each provider.

Providers must bill the MSN Program within 90 days of the date the service was received or 90 days from the date on the NOA letter, whichever, is later.

Note: Members may be responsible for payment if they fail to notify providers of their MSN eligibility status.

The MSN Program does not guarantee payment for all services. Members may be responsible to pay providers, if the Program does not make payment. The MSN Program will not pay for any service that is not within the Program’s scope of benefit.

The MSN Program has a very narrow network of providers. Except for emergency situations, please make sure that your practitioner accepts or will accept MSN reimbursement. The MSN Program cannot force any provider to accept MSN reimbursement.

There are several resources that may be able to assist with health care and other important needs:

• Most individuals who meet the eligibility criteria for the MSN Program qualify for financial assistance to purchase comprehensive, commercial health coverage through Covered California – California’s online health insurance marketplace. Please contact Covered California at 800-300-1506.
• Public Health referral line: (800) 564-8448. Provides referrals for medical needs including, immunizations, birth control, pregnancy tests, family planning and child health care.
• Partnership for Prescription Assistance: (888) 477-2669. Provides information about programs that may provide medications at low or no cost.
• The County of Orange provides funding through the TSR Program to a number of Orange County Community Clinics to provide low-cost and no-cost health care services to those without health coverage and may include certain services not covered by the MSN Program such as primary and preventive care and routine dental. For information, please contact the Coalition of Orange County Community Health Centers at 949-486-0458.