Mlk Care Medical Benefit Excellent care from doctors who care

More than a medical plan, MLK Care provides affordable, comprehensive care from MLK Community Medical Group physicians and other physicians in the community.

MLK Community Medical Group is committed to giving everyone in your family the highest-quality care. They specialize in primary and specialty care, disease management, and preventive services. They also screen for and treat physical and mental health issues and have award-winning diabetes care. In addition, the Fund provides special representatives to help you get the most out of your care with MLK Care.

You can view and manage your appointments, message your care team, securely view your lab results, and download and securely share your health records on the MLK Member portal. To set up your portal account you must have had your first primary care visit. Then, go to MLKch.org/self-enroll or call 844-484-2273.

MLK Care Medical Plan service area
Most medical care for the MLK Care Medical Plan is provided by the MLK Community Medical Group located in South Los Angeles. The service area for the MLK Care Medical Plan is 15 miles “as the crow flies” from the Martin Luther King, Jr. Community Hospital (the “MLK Hospital”) in South Los Angeles. If you do not live within the MLK Care Medical Plan Service Area, you can still choose to enroll in the MLK Care Medical Plan if you live or work within 30 driving miles of the MLK Hospital.

Medical expenses that are covered in whole or in part by the MLK Care Medical Plan are called Covered Expenses. This is a simple summary. See the Summary of Benefits & Coverage or Summary Plan Description in the Forms & Documents section of this website for complete details.

For information about limitations and exceptions, please request the Plan or policy document by calling 1-833-961-3021.

For other benefits, visit the following pages:

MLK Medical Plan provides care for your family at an affordable cost. Unless stated otherwise, this chart shows what you pay for covered expenses. Your primary care doctor handles all specialist referrals and gets approval for your medical care.

This is a simple summary. See the Summary of Benefits & Coverage or Summary Plan Description in the Forms & Documents section of this website for complete details.

Price Comparison Tool: santamonicaunitehere.medexperthealth.com

Primary care centers are your destination for coordinated, supportive, and caring medical care. Check the full, updated list of providers here . Call to make an appointment: (424) 529-6755.

UNITE HERE Health Center
Quality medical and dental care exclusively for MLK Care Medical Plan participants and their eligible family members.

1122 W. Washington Blvd, Suite 310
Los Angeles, CA 90015

East Compton Care Center
135 E. Compton Blvd.
Compton, CA 90220
Mon – Fri, 8:00 AM – 5:00 PM

Wilmington Care Center
Top-notch specialists in primary care, diabetes, cardiology, and more, with state-of-the-art technology.
12021 N. Wilmington Ave. Building 11, Suite 1000
Los Angeles, CA 90059
Mon – Fri, 8:00 AM – 5:00 PM

Specialist visits and other care will be coordinated by your MLK primary care doctor. Your primary care doctor will provide a referral and prior authorization for specialists or other care. You must only use providers and services that are in-network, except for the emergency room.

Wilmington Specialty Clinic
Top-notch specialists in diabetes, cardiology, and more, with state-of-the-art technology.

12021 N. Wilmington Ave. Building 11, Suite 1000
Los Angeles, CA 90059
Mon – Fri, 8:00 AM – 5:00 PM

Hinge Health
Hinge Health provides comprehensive care that includes working with a physical therapist, and doing exercise sessions that are personalized for you. At each stage, they supply the tools you need to boost your results. Best of all, it’s covered by the Fund. With Hinge Health you receive:

Carelon
Call Carelon at (888) 479-6606 for a broad network of providers for mental health and substance use disorder treatment, including:

MLK Care uses the First Health network for urgent care. Visit the First Health website to find an in-network location or call (800) 226-5116.

Martin Luther King Jr. Community Hospital
LA’s newest hospital with award-winning technology, high patient satisfaction, clean and welcoming.

1680 E 120th Street
Los Angeles, CA 90059
Open 24 hours, seven days a week
Emergency department entrance is off 120th Street, between Wilmington Avenue & Healthy Way

Avoid the Emergency Room (ER) unless you have a medical emergency. If you have a medical emergency, call 911 or go to the nearest hospital. If you go the ER for care that is NOT an emergency, the charges will not be covered.

MLK Community Medical Group providers, extended network providers, and network providers will generally submit health claims for you. Out-of-network providers may also submit health claims on your behalf. Health claims submitted by your provider will be processed as if they were filed by you. If you need to file a health claim yourself, please call the Benefit Administrative Office to request a claim form.

Health claims must be filed within one year after the date of service. Health claims filed after this deadline will be denied. If a MLK Community Medical Group provider, extended network provider, or First Health network provider does not file a health claim on time, the provider can bill you only for the copayment or coinsurance you would have paid if the provider had filed on time.

A health claim is considered filed on the date it is received by the Benefit Administrative Office (or on the date postmarked, if mailed to Benefit Administrative Office through the U.S. Postal Service), regardless of whether it contains all the information necessary to render a decision.

All health claims must be submitted to the Benefit Administrative Office by one of these methods: