California Counties Start Moving Medi-Cal Beneficiaries to Managed Care – The chronically ill persons..

On Wednesday, that is TODAY, 16 California counties will start enrolling about 380,000 Medi-Cal beneficiaries who are elderly or have disabilities in managed care plans.

Background

The move stems from the five-year, $10 billion Medi-Cal waiver the state secured from the federal government in November 2010. Funds from the waiver will go toward public hospitals and the expansion of local health programs. Anthony Cava — spokesperson for California’s Department of Health Care Services — said the new policy could reduce state spending by $365 million annually.

Details on Medi-Cal Shift

Previously, seniors and people with disabilities who had Medi-Cal coverage could choose whether to find their own physician or enroll in a managed care plan if one was available in their area.
Under the new policy, beneficiaries who live in counties that offer a managed care option will be required to sign up for that plan

The 16 counties that will be affected by the change are:

Alameda;
Contra Costa;
Fresno;
Kern;
Kings;
Los Angeles;
Madera;
Riverside;
Sacramento;
San Bernardino;
San Diego;
San Francisco;
San Joaquin;
Santa Clara;
Stanislaus; and
Tulare.

The shift to managed care will be phased in over the next year. Beneficiaries will need to select a plan by the month of their birthday, or the state will choose a plan for them.

Certain beneficiaries in the 16 counties will be exempt from the requirement, including:

Children in foster care;
Those who pay part of their Medi-Cal costs;
Those who receive coverage from both Medi-Cal and Medicare; and
Those who receive long-term care (San Francisco Chronicle, 6/1).

This is just the beginning of a 12 month transition, so i’m sure you’ll hear a whole lot more as this new wheel begins to spin and get implemented. Please don’t be in such a hurry as to not leave me a word or two on this post. I want what you folks want. Current Health Insurance news.

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