Myrna: Changes in Medi-Cal

I learned about some important changes to Medi-Cal at a recent meeting that I would like share with you. As you may know, a mandatory enrollment to the Medi-Cal Managed Care health plan will begin June 1, 2011. There will be a 12-month enrollment process—from May 2011 to April 2012—in which seniors and persons with disabilities with Medi-Cal coverage only (not Medicare) must enroll in the Medi-Cal Managed Care program. (With this change, many people won’t be able to stay in regular Fee for Service Medi-Cal.)  With Medi-Cal Managed Care, your benefits will remain the same, with the addition of: a provider directory, a member service number, a nurse advice line, a primary care doctor who will refer you to specialists and hospitals in your plan, and the choice of which health plan you want to enroll in. 

There are several important things you need to know about this change:

1. Again, this is mandatory for all seniors and persons with disabilities who have Medi-Cal only.
2. You must enroll by the end of your birthday month between May 2011 and April 2012. You will receive your enrollment package 90 days before the month of your birthday.
3. If you are currently under care, you can continue to stay with your present doctor for 12 more months.
4. If you do not choose a plan, you will be automatically enrolled in one.
5. You can ask your current medical providers which plans they accept, and you can also ask family and friends for help choosing a plan.
6. For now, the above change applies to people living in the following counties only: Alameda, Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus, and Tulare.
7. If you belong to one or more of the following groups, you will not be mandatorily enrolled into the managed care plan and this change does not apply to you:

• Dual eligibles, or those with Medicare
• Foster children
• Those identified as Long Term Care (LTC)
• Those with other health insurance
• Share of Cost (SOC) Medi-Cal
• California Children's Services (CCS)—although currently excluded, this group may be included in the future.

For additional information on these changes to Medi-Cal, visit http://dhcs.ca.gov/spdinfo.