Low Income Health Program (LIHP)

IMPORTANT UPDATE

Pharmacy Notice

Pharmacy FAQ

New Pharmacy Network Changes

LIHP & CMS Pharmacy Listing - English & Spanish

LIHP is a program that funds medical care for uninsured adult county residents.  LIHP uses a network of community health centers along with hospitals, community physicians, and mental health providers throughout San Diego County to provide health care services.

LIHP Enrollee Information

The Low Income Health Program (LIHP) will cover medical procedures that are deemed medically necessary by your LIHP doctor/network provider, services include:

• Access to a Primary Care Provider
• Outpatient and Inpatient Services
• Emergency Medical and Dental Services
• Limited Mental Health Benefits
• Specialty Care
• Prescription Drugs
• Vision Coverage

For more information, please consult the Enrollee Handbook below.

 LIHP Enrollee Handbooks

The following handbooks provide information about LIHP:

• Enrollee Handbook - Provides LIHP information on how to receive health services for LIHP enrollees.
• Enrollee Handbook (Español) - Proporciona información sobre LIHP de como recibir servicios de salud para miembros de LIHP.
• LIHP Enrollee Rights - Provides LIHP information on Your Rights.
• LIHP Rights & Responsibilities - Provides LIHP information of your Rights and Responsibilities as part of the application for, and receipt of LIHP.

LIHP Minimum Eligibility Criteria

Individuals may be eligible for LIHP if they meet the minimum eligibility criteria.

• Does not meet the Medi-Cal eligibility criteria
• 19 through 64 years of age
• A San Diego County resident
• A US citizen or legal alien with 5 years residency (with some exceptions)(for Citizenship click here).
• Meet LIHP financial requirements
• Click here for LIHP income limits

There is no property evaluation for LIHP.

How to Apply

Click here for more information on how to apply for LIHP.

To check on the status of your LIHP application pending in a FRC, you may leave a voice message at the following phone number.  All voice mail messages left on the FRC LIHP line should be returned within 1 business day.

If you have a LIHP question or would like more information please send us an email 

LIHP Provider Information

• Provider Treatment Authorization Phone Number is 858-658-8650.
• Medical Management Fax Number is 855-394-7927.

  LIHP Service Forms

• LIHP Formulary
• Drug Prior Authorization Request form
• Formulary Change Request form
• LIHP Formulary-Psychiatric Medication Subset
• LIHP Medical Policies
• Specialty Referral Guidelines
• LIHP-CMS Pharmacy Listings
• LIHP Information Flyer (English & Spanish)
• Billing Authorization Form-Language Line Service
• Services Authorization Form and Instructions for In-Person Interpreter
• LIHP Provider Frequently Asked Questions (FAQ's)

LIHP Provider Handbook

• LIHP Provider Handbook - Information on  how to provide health services to LIHP enrollees.

How to become a LIHP/CMS Contracting Specialty Provider

Become a contracting provider and gain access to the Electronic Treatment Authorization System (eTAR) and Provider Online Verification (POV) website!

• LIHP Specialty Contracting Informational Flyer
• eConsult Contracting Informational Flyer
• Specialty Contracting Application Packet

Are you already a specialty contracted provider?  

See how you can add eConsult services to your existing contract.

• eConsult Contracting Informational Flyer
• eConsult Contract Amendment Request

Specialty Contracting Providers Change Notification.

Has there been a change to any of the following?

• Site Address
• Tax Identification Number (TIN)
• National Provider Identification Number (NPI)
• Provider Change
• Additional Provider Added to Group

If so Please fill out and submit the Contracting Providers Change Form.

Non-Contracting Provider Changes

• New Providers & Change of Address Form

How to become a LIHP/CMS Ancillary (Non-Specialty Services) Provider

Become a contracting ancillary provider and gain access to the Electronic Treatment Authorization System (eTAR) and Provider Online Verification (POV) website!

• LIHP Ancillary Contracting Informational Flyer
• LIHP Ancillary Contracting Application Packet

Ancillary contracting providers change notification.

Has there been a change to your LIHP/CMS contract contact, site address or providers within your facility? Please click here to email contract change notifications.

How to become a LIHP/CMS Primary Care Clinic Provider

Establish a NEW Primary Care Clinic contract with LIHP.

• LIHP Primary Care Clinic (PCP) Contract Application Packet

To add an ADDITIONAL site to an already contracting LIHP PCP site.

• LIHP Primary Care Clinic (PCP) Additional Site Request Form

Please click here if you would like more information on the LIHP contracting process.