The Department of Health Care Services (DHCS) has launched a statewide effort to help Medi-Cal beneficiaries keep their Medi-Cal coverage or get enrolled in other coverage in preparation for the end of the COVID-19 public health emergency (PHE) and the end of the federal Medicaid continuous coverage requirement.
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A DHCS spokesperson told State of Reform that this effort, the largest of its kind, is one of many being launched across the nation as state Medicaid programs and Children’s Health Insurance Programs (CHIP) will soon begin the process of redetermining eligibility for the 85 million people nationally who use these programs to access health care.
Medi-Cal enrollment has increased from 12.5 million in March 2020 to 14.5 million today–a nearly 16% increase. According to DHCS, the beginning of the eligibility redetermination process will result in two to three million beneficiaries no longer being eligible for Medi-Cal.
One of the key aspects of this state effort is the release of a customizable Medi-Cal Continuous Coverage toolkit and webpage to help “trusted entities and individuals” act as DHCS Coverage Ambassadors.
DHCS Coverage Ambassadors will include providers, managed care plans, local county offices, health navigators and advocates, community-based organizations, and other entities. They will help push communications to Medi-Cal beneficiaries to encourage them to update their contact information with their counties to ensure they receive important information about keeping their Medi-Cal coverage, and will communicate this information in “culturally and linguistically appropriate ways.”
The spokesperson emphasized the importance of these coverage ambassadors in helping beneficiaries maintain their Medi-Cal coverage.
“The unwinding of the federal Medicaid continuous coverage requirement necessitates a coordinated, phased communications plan to reach beneficiaries with messages across multiple channels using trusted messengers … As California plans to resume normal Medi-Cal eligibility operations, beneficiaries will need to know what to expect and what they need to do to keep their health coverage …
The top goal of DHCS is to minimize beneficiary burden and promote continuity of coverage for our beneficiaries. DHCS Coverage Ambassadors will deliver important messages to Medi-Cal beneficiaries about steps they can take to help maintain their Medi-Cal coverage after the COVID-19 PHE ends.”
The spokesperson stated that they are collaborating closely with local county offices, other state departments, Medi-Cal health plans, and community partners to develop effective strategies to continue extending Medi-Cal coverage for beneficiaries once the PHE ends. Beneficiaries no longer eligible for Medi-Cal may qualify for tax subsidies that allow them to access affordable coverage through Covered California, or they may be eligible through their employer-based health coverage.
Consumers eligible for the Covered California financial assistance program will need to confirm their selection of a Covered California health plan and pay any required premium within a month of their disenrollment from Medi-Cal.
The spokesperson said DHCS is also enhancing existing policies and business procedures “… to increase efficiencies in case processing and to reduce barriers to continued coverage, including updating policy guidance, exploring other federal eligibility flexibilities, and incorporating Medi-Cal retention strategies developed by CMS.”
DHCS encourages Medi-Cal and CHIP beneficiaries to report any changes in their personal circumstances, such as income, pregnancy, a new household member, or address, to their local county Medi-Cal office online, by phone, or in person. DHCS also encourages beneficiaries to check their mail for upcoming renewal packets.