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Affordable Care Act & Seniors

Are You on MediCAL and Medicare? IF YES, You need to know about MediConnect


 

1) What is Cal MediConnect?
Cal MediConnect brings together and coordinates all the health care and social services that you now get through Medicare and Medi-Cal into one managed care health plan.
 
2) Where is Cal MediConnect being implemented?
Cal MediConnect is being piloted in eight counties: Alameda, San Mateo, Santa Clara, Los Angeles, Orange, San Diego, Riverside, and San Bernardino
 
      3) When does Cal MediConnect start?
The current start date for Cal MediConnect is April 1, 2014.
 
      4) What Medicare and Medi-Cal Services will Cal MediConnect coordinate?
üMedicare pays for: doctors, specialists, hospital care, prescriptions, and some durable medical equipment.
üMedi-Cal pays for: IHSS, adult day health care, MSSP, hearing aids, incontinence supplies, medical equipment, and also pays your Medicare co-payments and deductibles.
 
      5) What are my choices about participating in Cal MediConnect?
1)    Enroll in Cal MediConnect Medicare/Medi-Cal plan that manages your Medicare and Medi-Cal services OR
2)    Keep your original Medicare AND enroll in an approved Medi-Cal managed care plan for Medi-Cal services.
 
6) Will I lose IHSS hours or my IHSS worker if I participate in Cal MediConnect?
No, you do not lose any IHSS hours, you continue to manage your IHSS worker, and have a DPSS social worker. 
 
7) If I want to participate in Cal MediConnect, what are the approved health plans in my county?
The approved plans are specific to each of the eight counties. If you live in one of the eight counties listed above, check www.calduals.org to your local HICAP agency  (800) 824-0780 to identify the plans for your county. 
 
      8) Why would I want to participate in Cal MediConnect?
üTo coordinate services from your doctors, specialists, medications, and other services. 
üYou have team to coordinate your doctors and pharmacists and all aspects of your care and services.
üAll Cal MediConnect plans will provide dental coverage, eye care, non-emergency medical transportation.
 
9) Can I keep my doctors if I enroll in Cal MediConnect?
1—Yes, you can keep your doctor if your doctor is a provider in one of these plans; 
2—If your doctor is not in one of these plans, you can continue to see your doctor for 6 months. Talk with your doctor about whether he or she will join one of the plans. You can decide not to participate in Cal MediConnect.
 
10) If I enroll in Cal MediConnect and decide I don’t like it, can I get out?
You can get out of Cal MediConnect and return to original Medicare, but you still have to select a Medi-Cal plan. 
 
11) When will I have an opportunity to decide about enrolling or not enrolling?
There will be an open enrollment period in all eight counties but we don’t know the dates and other details at this time. If you are in one of the eight pilot counties, check with www.calduals.org or your local HICAP agency for more information on the enrollment plan. 
 
12) What happens if I don’t make a choice during the open enrollment period?
If you don’t select a plan during open enrollment, the state will enroll you in a Cal MediConnect period. For more details on this, call one of the organizations listed below.
 
13) How can I get help in making this decision?
Call your local HICAP agency, for help and information: (800) 824-0780
 
Distributed by CARA, 600 Grand Ave. Suite 410, Oakland, CA 94610, (510) 663-4086, (714) 244-7776        

BREAKING NEWS!!!!