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Medi-Cal Renewal Now Automatic for Eligible Californians

by admin on 4th-June-2015

McKenzie Jackson, California Black Media

McKenzie Jackson, California Black Media

Los Angeles County resident, Diyon Clark, is relieved to learn that his Medi-Cal renewal will be automatic this year. In 2014, he remembers his re-certification process being especially confusing and frustrating.

“That’s cool,” said Clark, a 20-year-old who lives in the San Fernando Valley. “That is one thing I hopefully won’t have to worry about.”

Late last year, the California Department of Health Care Services (DHCS) announced that county human services agencies across the state will renew coverage for most Medi-Cal members by using the information they already have on file. That includes information pertaining to a person’s place of residence, immigration status, and income. If the county is able to verify all of an individual’s information their coverage will be renewed.

In a March 25th email, DHCS spokesperson Anthony Cava said re-certifications begin well ahead of the date members’ plans are set to expire.

“For renewals due January 1, 2015,” he wrote, “the process started approximately 60 days in advance (end of October/early November 2014).”

For Californians who qualify, Medi-Cal offers health care benefits at either no or low cost. The coverage funds a prevention-oriented approach that promotes well-being through 21 managed and county-specific health plans such as Anthem Blue Cross, L.A. Care and Molina.

The health program is open to low-income adults; individuals with disabilities; families with children; senior citizens; children in foster care as well as former foster youth up to age 26; and pregnant women. According to numbers from DHCS, as of last month approximately 927,280 African Americans were enrolled in Medi-Cal.
This year, DHCS expects to renew the insurance plans of about 12 million Medi-Cal members. “If all the information is available and it indicates continued eligibility, the individual’s coverage will be continued for another 12 months,” said Cava Clark, who is half African American and half Jewish and has been covered by Medi-Cal for most of his life, says the most painful part of his renewal process last spring was completing it by phone.

“It took about three months for me to get renewed,” said Clark, a college student and wireless phone salesman. “I was told to call and ask for Medi-Cal, then Covered California, then Medi-Cal.”

Clark said needing to have surgery on his torn rotator cuff last year further complicated the process and heightened his frustration. And he was not the only person angered by the 2014 renewal process. There was a significant amount of chatter among health care advocates and Medi-Cal users alike, lamenting the fact that due to the implementation of the Affordable Care Act (ACA), the questions asked on the renewal forms had become too complicated.

Elizabeth Landsberg, director of legislative advocacy at the Sacramento office of the Western Center on Law & Poverty, an organization that works to secure housing, health care, and a strong safety net for low-income Californians, said the renewal process seems to be more streamlined now.

“The process we have been seeing in 2015 is quite different,” she said.

“Essentially in the past we had been expecting people to re-apply for Medi-Cal all over again. Now the onus is on the state to check people’s records.

Cava said Medi-Cal users will only have to complete renewal forms if their Medi-Cal service cannot be automatically renewed, for example DHCS cannot verify certain information like income or residency.

“Then, a pre-populated renewal form is sent to them, outlining the information used for the redetermination and what information is still needed from them to complete the renewal process,” he said.

Cava said that any forms must be completed within a 90-day period or a current enrollee could lose his or her Medi-Cal coverage.

“This is our standard Medi-Cal policy,” he said. “If the information is provided within this timeframe, the counties will accept the information as if it had been submitted on time and complete the redetermination process. If the person remains eligible, their coverage will resume and be treated as if there was never a break in coverage.”

Besides providing an opportunity to have surgery on his rotator cuff, Clark says having Medi-Cal also allowed him to have surgery on his broken right hand – all within the past year. Inserting a metal plate into one of his appendages wasn’t cheap, he said.

“Medi-Cal has saved me at least $20,000 in medical bills, easily” he said.
For more information on renewals, visit your local county human services agency, go to www.coveredca.com/medi-cal/renewing-medi-cal-coverage/ online or call 1-800-300-1506.

Category: Point of View.
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