LOS ANGELES – On May 29, Cal MediConnect was launched for ‘dual eligibles’ living in Los Angeles County at St. Barnabas Senior Services Center.
According CalDuals.org, dual eligibles are those “who receive health care services through both the Medicare and Medi-cal (Medicaid nationally) programs.”
In an ethnic media roundtable discussion conducted by New America Media (NAM), elders and service providers expressed their concerns about the Cal MediConnect program.
Cal MediConnect (which is part of California’s larger Coordinated Care Initiative/CCI) is a program that offers health benefits and services for seniors and people with disabilities, who are dual eligibles (availing of both Medi-Cal and Medicare program benefits.)
CalDuals.org states that the purpose of CalMediConnect is “to improve care coordination for dual eligible beneficiaries and drive high quality care that helps people stay healthy and in their homes, for as long as possible.”
According to NAM Executive Director Sandy Close, more than 200,000 LA residents are eligible for Cal MediConnect.
Enrollment discrepancies
Neighborhood Legal Services of LA County Supervising Attorney Stephanie Lee said in the forum that Cal MediConnect enrollment has become a huge problem to many individuals (particularly in LA County) due to confusion on notices and enrollment forms, no responses from blue envelopes (containing Cal MediConnect information), problems with healthcare options and lack of information about the new healthcare program.
Filipino American Service Group, Inc. (FASGI) client Anacleto Mendoza, who was one of the panelists, complained about the Cal MediConnect enrollment process.
“My doctors didn’t answer my questions [regarding the processing of my Cal MediConnect enrollment]. We need to be more educated in Cal MediConnect. I have to wait and see the next steps,” Mendoza said.
Enrollment choices
Cal MediConnect has three enrollment options, depending on your county of residency and your Medi-Cal managed care plan.
(1) Eligibles can voluntary enrollment in the program itself (combining your Medicare and Medi-Cal benefits)
(2) People can choose to opt out of the program, but are required to enroll in a Medi-Cal plan.
(3) People ages 55 and older, who need a higher level of nursing home care, must enroll in the Program of All-Inclusive Care for the Elderly (PACE) program.
PACE provides all Medicare and Medi-Cal benefits and services to help seniors (who have chronic conditions) to live at home.
Starting July 2014, Cal MediConnect passive enrollment will be implemented for ‘dual eligibles’ who have not signed up in the health plan during the 90-day period of voluntary enrollment (April-June 2014).
All qualified individuals will be automatically enrolled, unless they decide not to, and unless they inform the state that they do not intend to join the health plan.
As of May 1, 2014, California Department of Health Care Services statistics shows that 15,322 Los Angeles residents have already enrolled and 37,373 will be enrolled in Cal MediConnect.
(www.asianjournal.com)
(LA Weekend June 7-10, 2014 Sec A pg.1)
