The following FAQs are subject to change based on regulatory changes, requirements, and
additional guidance from the Department of Health Care Services (DHCS) and the
Centers for Medicare and Medicaid Services (CMS).
DHCS, in conjunction with CMS, is launching a three-year demonstration to enroll beneficiaries who are covered by both Medicare and Medi-Cal (dual-eligibles) into managed care health plans. Enrollment in the Dual Eligible Demonstration, now known as Cal MediConnect, begins no sooner than January 1, 2014, in eight counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara). Eligible beneficiaries will begin receiving notification of changes and choices starting in October 2013.
The goal of Cal MediConnect is patient-centered care. DHCS, CMS and their plan partners want to improve access to care, coordination of services, ensure continuity of care and increase availability and access to home- and community-based services, so beneficiaries have better health outcomes and remain in their homes and communities as long as possible.
Cal MediConnect is available to individuals who meet all of the following criteria:
Enrollment in Cal MediConnect is voluntary and occurs through a passive enrollment process. The passive enrollment process is phased in with county-specific timelines. Eligible beneficiaries receive multiple notices describing their choices about enrolling in Cal MediConnect. Eligible beneficiaries who do not notify the state they choose to opt out and do not choose a Cal MediConnect plan are passively enrolled in Cal MediConnect by the state.
After Cal MediConnect enrollment begins, eligible beneficiaries may voluntarily enroll or opt out at any time without waiting for their assigned month of passive enrollment.
Individuals who may enroll in Cal MediConnect, but are exempt from passive enrollment, include:
Services include, but are not limited to:
Health Net is committed to providing current information on Cal MediConnect as it develops. Check Health Net’s provider website at www.healthnet.com/provider for updates. Information is also available on the CalDuals website at www.calduals.org and through CMS.
To provide you with the most accurate plans and information in your area, we need to know your location. Please enter a ZIP code for Arizona, California, Oregon, Washington.
To provide you with the most accurate plans and information in your area, we need to know your location. Please enter a ZIP code for Arizona, California, Oregon, or Washington.