Health Net hones in on Medi-Cal redetermination efforts as millions may lose coverage
While the COVID-19 pandemic brought endless challenges, Medi-Cal beneficiaries were able to maintain their coverage for three consecutive years, but due to the end of the federal public health emergency’s continuous Medicaid coverage requirement, California is beginning to disenroll members who are deemed no longer eligible. Health Net, a Medi-Cal health plan, is honing in on their efforts to inform and support members throughout this process.
California began its redetermination process on April 1st for beneficiaries with a June renewal date, and the first disenrollments from Medi-Cal are expected to occur in July. Counties have 14 months to initiate and complete redeterminations, and local county offices will conduct a full renewal for all enrolled in Medi-Cal via auto-renewals and requests for additional information when necessary.
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Members who have renewal dates for this month will receive a notice of action no later than June 20th if the renewal packet is incomplete, or if the beneficiary is no longer eligible.
Darrel Ng, vice president of communications and marketing for Health Net, spoke with State of Reform about the plan’s work to assist members with maintaining Medi-Cal coverage.
“There are 15 million Californians on Medi-Cal, and the state estimates that two-to-three million people will lose coverage during this redetermination process,” Ng told State of Reform.
According to Ng, studies project that about 50% of individuals who are estimated to lose coverage will be for reasons such as obtaining a higher paying job that surpasses the Medi-Cal income limits. For the other half of individuals who are expected to fall off Medi-Cal, Ng said it will be because they did not jump through the bureaucratic hoops needed to maintain coverage.
These hoops include ensuring Medi-Cal beneficiaries update their contact information. If a beneficiary’s contact information is up-to-date in their local Medi-Cal office, they will receive a letter in the mail saying the beneficiary has been automatically renewed, if the person is deemed eligible.
If the local Medi-Cal office does not have all updated contact information for an individual, the individual will be mailed a yellow envelope with a pre-populated renewal form. Individuals who are deemed ineligible will receive a letter stating they are no longer eligible, or that their Medi-Cal has ended.
“If you are a Health Net member, we will send you mail, and emails, and texts—to the extent that we have that information about you—right before it’s your turn to redetermine,” Ng said, adding that the plan’s goal is to notify members of their redetermination dates, and that they should be on the look-out for a yellow envelope to fill out and return.
Keep yourself and your family covered. Log into your account to make sure Medi-Cal has your current address, email address, and phone number, if it has changed. Visit https://t.co/u6zr0zDdjb today. pic.twitter.com/nhAY6Gv4I9
— Health Net, LLC (@HealthNet) May 19, 2023
Individuals can update their contact information in four ways: by mailing back the packet that they received, calling the local county that they reside in, walking into a local county health office, or doing so online. Health Net will reach out to members one month prior to their redetermination date, and during what is called the “pending phase.”
“We get a file from the state if they don’t return the information, and at that point, that’s when they get the second set of mail, robo calls, live calls, and texts [from Health Net],” Ng said.
Ng said there are 19 ways for beneficiaries to learn about the redetermination process, including through updated information on Health Net’s website and social media messaging. Health Net has also set up a system so that when beneficiaries call, customer service representatives can inform the members that their redetermination date is around the corner.
“Out of the 19 ways we’ve set it up to contact people, we feel like we are making every reasonable effort to reach these members and inform them that they need to fill out this information, and then at the end of that cycle, the state prohibits us from contacting these members further because they are technically no longer our members,” Ng said.
On top of direct communication with members, Health Net launched a public education campaign, called “Review to Renew,” to reach members who don’t regularly check their mail, or don’t have consistent access to email or text messaging. Health Net is also leveraging their partners, community-based organization, and faith-based organizations to spread the word.
“We are working with the LA County Office of Education to share a digital toolkit with all school districts in LA County,” Ng said, adding that Health Net wants to get into school communication channels to make sure parents and families are aware of the redeterminations.
“We are trying to be at cultural and community events to share information about redeterminations, and last month, we did 11 events,” Ng said, sharing that the plan was present at Cinco de Mayo festivals.
Medi-Cal providers will also receive posters from Health Net in the next several weeks, which will be in both English and Spanish and have command strips attached to the back.. So far, providers have asked for 30,000 copies of their flyers, and Health Net is in the process of translating the flyers into California’s additional 15 threshold languages.
“There are a million, a million-and-a-half people who qualify for Medi-Cal who aren’t going to have it at the end of this process, and we have an obligation to do our best to make sure these people retain coverage, because we know how important coverage is to having a better life,” Ng said. “We know that this is our challenge for the year, and how we can positively affect our community.”