On June 1, 2011, the following California counties will begin a 12-month process of welcoming newly enrolled beneficiaries into their managed care plans: Alameda, Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus, and Tulare.
This reassignment is part of a “bridge” from Fee-For-Service (FFS) Medi-Cal to the complete implementation of the Affordable Care Act by year 2014.
As of now, Fee-for-Service MediCal recipients are receiving letters directing them to enroll in a Medi-Cal Managed Care Plan by the end of their birthday month. The letter also states that if a plan is not chosen by the deadline, one will be randomly assigned.
Mandatory enrollment does not apply to Medi-Cal/Medicare (Medi-Medi or “dual eligibles”) recipients or to:
• Those who are Foster Children
• Those identified as Long Term Care (LTC)
• Those who have Other Health Insurance
• Those who have Share of Cost (SOC) Medi-Cal
• Those who are California Children's Services (CCS) recipients (Although currently excluded, this group may become mandatory in the future)
This change does apply to those with Medi-Cal only and no Share-of-Cost. MediCal Aid Codes affected by the change are: 20, 24, 26, 2E, 2H, 36, 60 (SSI-linked Medi-Cal), 64, 66, 6A, 6C, 6E, 6G, 6H, 6J, 6N, 6P, 6V, 10,14, 16, 1E, 1H.
For those with special needs Medical Exemption Request can be submitted. This may allow those requiring continued standard Fee-for-Service Medi-Cal to remain in effect The form can be found at:
The plans available in Los Angeles County are:
Positive Healthcare (800) 263-0067
AltaMed (PACE) (323) 728-0411
Health Net Community Solutions, Inc. (800) 675-6110
L. A. Care Health Plan (888) 839-9909
SCAN Health Plan (877) 452-5898
For information about the plans and to find comparison charts go to http://www.healthcareoptions.dhcs.ca.gov for more information or call Michael Van Essen, Director of Benefits Establishment, 626-254-5043.