Important Changes to Medi-Cal in 2022
COVID Public Health Emergency – Dpt of Health and Human Services has extended it for another 90 days, scheduled to expire Mid July 2022. Regarding Medi-Cal Benefits, the counties will be preparing for this transition. Medi-Cal offices have not been taking negative actions. (i.e, termination of benefits due to lack of renewal or increase income, etc) on some Medi-Cal cases due to PHE.
To help our families and individuals served to keep their MC benefits active I would recommend the following:
A. Make sure Medi-Cal office has their current contact information including mailing addresses and phone numbers – Medi-Cal will send all sort of notices to beneficiaries to either confirm benefits are renewed or provide a renewal packet, or send an NOA letter if benefits will terminate
B. If family or individual served has received a renewal packet they need to complete and submit on time. Encourage them to contact the worker to confirm receipt or it’s still missing information. Or if family is wondering why they have not received a renewal packet, they need to call Medi-Cal. Do not wait until July !
1. Medi-Cal Rx – Implemented on January 1, 2022. Dpt of Health Care Services transitioned Medi-Cal pharmacy benefits and services from Medi-Cal Managed Care Plan (CenCal Health & Gold Coast) to Fee For Service Delivery system. These benefits are now administered by Magellan Medicaid Administration, Inc. This means Managed Care Plans (CenCal Health & Gold Coast) are no longer responsible for providing or approving prescription drug coverage or related medical supplies for Medi-Cal beneficiaries. There are some exceptions to this change.
If the person served or the family have been having challenges with theses changes or not able to get their medications, they should be supported by the medical provider prescribing the medication, the pharmacy involved and if possible include CenCal Health or Gold Coast case management. Magellan Customer Service Center is also available 24 hrs/day, 7 days/week – 1(800)977-2273
Medi-Cal FAQs Update 2/23/22 https://www.dhcs.ca.gov/provgovpart/pharmacy/Documents/Transition-Medi-Cal-Pharm-Services-MC-FFSFAQsV11.pdf
DHCS Medi-Cal Rx https://www.dhcs.ca.gov/provgovpart/pharmacy/Pages/Medi-CalRX.aspx
More information in Box Folder Medi-Cal Rx 2022 https://tcrc.box.com/s/sb4et8mfppx2mbtnw8zulyc38txe1woj
Please note, this change does not affect those who get their medications under Medicare Part D.
2. Medi-Cal Expansion to Older Adults Age 50 & Older – As of May 1, 2022, Medi-Cal expansion extends eligibility for Full Scope Medi-Cal to all people who are 50 years or older, who meet all Medi-Cal eligibility criteria, regardless of immigration status. If the person currently has restricted Medi-Cal benefits, in May 2022 that person will automatically transitioned to full scope (full benefits) Medi-Cal. DHCS has sent notification/s to all who will be affected by this change. They will be enrolled in the Managed Care Plan (CenCal Health /Gold Coast) the same month or the following month after the implementation. Once they are enrolled with CenCal Health or Gold Coast, the beneficiary will receive a New Member Packet and information with the ID card.
If you know of a person served who does not have Restricted Medi-Cal but could qualify based on income and resources, I would encourage them to apply now.
DHCS Older Adult Expansion https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx
DHCS FAQS (include List of Full Scope Benefits ) https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/OAE/Older-Adult-Expansion-FAQ.pdf
More info in Box Folder Medi-Cal Expansion to Older Adults https://tcrc.box.com/s/y20yv8k8by1yon8fyllhm4nuvhszo3np
3. Medi-Cal & Asset Limits Increase – As of July 1, 2022 The Asset/Resource Limit for Non-MAGI Medi-Cal Programs for People who are 65 or older or disabled is increasing. Currently the asset limits are $2000 for one person and $3000 for a couple. The new limits will be $130,000 for one person and an additional $65,000 for each additional family member. The Non-MAGI Medi-Cal Programs to be affected by this regulation include “Aged & Disabled, Medically Needy with a SOC &, LTC Medi-Cal.
The asset limits will also increase to $130,000 for Medicare Savings Programs- MSPs : QMBs, SLMB, QI, QDWI) The MSPs, help low income Medicare enrollees pay for Medicare out of pocket expenses including premiums and cost sharing.
Please note those who have Medi-Cal linked SSI (Supplemental Security Income) the asset limits still remain the same, $2,000 for a single person.
DHCS Asset Limits Changes for Non- MAGI MC https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Asset-Limit-Changes-for-Non-MAGI-Medi-Cal.aspx
More Info in Box Folder Medi-Cal Asset Limits Increased – https://tcrc.box.com/s/edugp8pfgg71elfvbrg0z1gvrinni8tq