Online Enrollment & Quotes for Cal Medi Connect
Online Enrollment & Quotes for Medi Medi MAPD Plans
Cal Medi Connect Los Angeles
Cal Medi Connect
Cedars Sinai
Cedars Sinai – Plan Section Tool & Info
getting-keeping-coverage
Non MAGI Medi-Cal

Cal Medi Connect program

Medi Medi – Medi care & Medi-Cal   Plan (MMP – Dual Eligible)

Must you choose a Medicare Advantage Plan & Medi-Cal HMO or one will be chosen for them?

Option A Medicare & Medi-Cal in ONE plan (Los Angeles Options)

Option B Keep Medicare  (Get an Advantage Plan)  and get a Medi-Cal Plan (Los Angeles)  Cal Duals.org    Cedars Sinai

Consumer Links

Get FREE Quotes & Enroll in Medicare Advantage – Note we get a finders fee, but are NOT your agent.

Cal Duals.org  *  Guidebook * Their email address  [email protected]

Our website on Medicare Advantage Plans

Cedars Sinai Tool & Information – How to OPT OUT!  Also applies EVEN if you don’t use their facilities!

dhcs.ca.gov  Technical Page on Cal Medi-Connect Demonstration

Health Care Options  844.580.7272  – State Enrollment Broker – Enroll & Dis-enroll

HICAP   – CA Health Care Advocates – 1-800-434-0222

See our Medi Cal Page

Medi-Cal Providers

Provider List by County

Los Angeles Times 2.1.2015 Problems with shifting care for costly patients

DHCS.Gov Medi-Cal Managed Care

ca health advocates.org (Medi-Cal)

LIS – Low Income Subsidy
(Medicare Part D Rx – Help with Drug Costs)

Doctor’s can’t bill Medi Medi patients for Co Pays, Deductibles, etc.

InsureMeKevin.com   on Blue Cross SNP & Dual Eligibility with Medi-Cal

Fraud, Waste & Abuse

Justice in Aging  duals demo advocacy.org/

Cal Medi Connect Toons

 

Transition to Medi-Cal Managed Health Plans

 

 

explains the enrollment process, options, and resources available for people who qualify for Cal MediConnect, a new health plan choice for Californians who have both Medicare and Medi-Cal.
January 2014  overview of both Cal MediConnect and Medi-Cal Managed Long Term Services and Supports, highlighting what the changes are, when to expect them, and how to make a decision.
More Video’s on Cal Medi Connect

Other pages in Medicare Advantage Section

Additional Social Services – in addition to Medi-Cal

Medi-Cal Estate Recovery

Blue Cross Medi Medi – Co Ordination Plan 

Technical Links

SB 1008 and SB 1036

CMS Reporting Requirements and other technical stuff

Dual Eligible Performance Studies – Inovalon

Needs assessment checklist

Problems with Medi-Medi – unwitting Guinea Pigs real clear policy.com

12 comments on “Cal Medi Connect – Medi-Cal & Low Income Programs

  1. my husband is on medi-medi and has been so for quite some time due to mental illness…

    he is in a long term nursing facility and decompensates yearly so he has to go to an outside mental health hospital….

    I was told that his [190] hospital days are up and they have to send him to a hospital that will take only medi-cal.

    how do I find out how many days is he entitled to and do they accumulate…..

    how may hospital days(mental health) are medi-medi claimants allowed p/year or lifetime? and what happens if they run out?

    who can I call to check his days available?

    need number to contact someone….

    pat

  2. Hello Mr. Shorr.

    1. How does an individual get true and actionable information regarding Medi-Medi; Medicare; and Medi-Cal?

    2. and how much information is available from you

    3. before a retainer or signing you on as active Counsel is required?

    Thank you for your response.

    Regards,

    Larry

    • 1. Check our pages on Medi Medi – above, the menu above for Medicare and here’s our Medi-Cal WebsiteEligibility.

      2. See the website and follow the links and use the ask a question feature on the relevant page.

      3. We are not attorneys. We can help you with Medicare Advantage to co-ordinate with Medi-Medi. See child pages above.

  3. My 92 year old mother is on Medi-cal and Scan, but needs to go into assisted living with waiver application they won’t accept Scan said she has to drop it, does she automatically go on Medi–Medi and will her new doctor take it? The application takes 3-6 months for approval but I have to drop her from Scan insurance before I fax over the waiver form…Any suggestions are appreciated.

    ***See our new ALW – California Assisted Living Page.

  4. My disabled niece has misplaced her medi medi card and since she does not speak I am trying to help her out, where/how does she get it replaced?

  5. I am confused. We have aarp Medicare advantage Hmo plan and our Doctor recommended that we also have medi medi care card for assistance as we are deaf, disabled living on fixed social security incomes.Can you elaborate/explain and are we eligible for additional help?
    Brad & Dianna K. We are 77 and 75 in 2017.

  6. Hello.

    I am the social security payee for my mentally challenged adult son who lives in California. One of his papers I have says he qualifies for extra help, and is Medi Medi, without a share of cost.

    He is coming to visit me in Indiana for three months. During that time, his psychiatric medications will be mailed to me for him, so that’s not a problem.

    But what if he gets the flu or is injured, such as a broken arm, appendicitis, etc. Will doctors in Indiana be able to treat him?

    Thank you.

    • Assuming your son still has his Medicare Card, Parts A Hospital and B Doctors would pay anywhere in the USA. See “Medicare & You” Page 38 et seq for Part A Coverage and Page 43 for Part B.

      Outside of CA Medi-Cal (CA version of Medicaid) only pays for emergencies… Learn More DSS.Cahwnet.Gov Out-of-State Provider Unit at (916) 636-1960. Learn More Medi-Cal.ca.gov

      This page may help you find a provider that accepts Medicare, Medi-Cal & Medicaid. Just about every MD accepts Medicare.

      FAQ’s from Medi-Cal’s Website

      18. What is a temporary out-of-state provider?

      The Out-of-State Provider Unit may enroll certain out-of-state providers and allow payment for up to $599.99, or 10 paid claim lines per calendar year, before they are required to complete the standard enrollment forms. Once this billing limit is reached, the provider is informed through a system-generated letter that enrollment as a permanent provider in the Medi-Cal program is necessary prior to receiving further payment. The letter instructs the provider to bill Medi-Cal again for non-paid claims after the Department of Health Care Services (DHCS) has received and approved a provider’s enrollment. Providers unable to use the temporary enrollment format should complete the permanent provider enrollment forms available on the Medi-Cal website’s Provider Enrollment webpage. For questions about which forms to use, contact the Out-of-State Provider Unit at (916) 636-1960.

      14. What is Share of Cost (SOC)?

      Some Medi-Cal recipients must pay, or agree to pay, a monthly dollar amount toward their medical expenses before they qualify for Medi-Cal services. This dollar amount is called Share of Cost (SOC). A Medi-Cal recipient’s SOC is similar to a private insurance plan’s out-of-pocket deductible.

      Recipients are not eligible to receive Medi-Cal benefits until their monthly SOC dollar amount has been certified online. Certifying SOC means that a provider has verified that a recipient has paid or become obligated to pay the entire monthly dollar SOC amount owed. Claims submitted for services rendered to a recipient whose SOC is not certified through the Medi-Cal eligibility verification system will be denied. Learn More Medi-Cal.ca.gov

Leave a Reply

Your email address will not be published.