On Wednesday, 16 California counties will start enrolling about 380,000 Medi-Cal beneficiaries who are elderly or have disabilities in managed care plans, the San Francisco Chronicle reports.
Medi-Cal is California's Medicaid program (Colliver, San Francisco Chronicle, 6/1).
The move stems from the five-year, $10 billion Medi-Cal waiver the state secured from the federal government in November 2010 (California Healthline, 3/7). Funds from the waiver will go toward public hospitals and the expansion of local health programs (San Francisco Chronicle, 6/1).
Anthony Cava -- spokesperson for California's Department of Health Care Services -- said the new policy could reduce state spending by $365 million annually (Hines, Riverside Press-Enterprise, 5/29).
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 (San Francisco Chronicle, 6/1). The 16 counties that will be affected by the change are:
- Contra Costa;
- Los Angeles;
- San Bernardino;
- San Diego;
- San Francisco;
- San Joaquin;
- Santa Clara;
- Stanislaus; and
- Tulare (Department of Health Care Services fact sheet, 6/1).
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).
On Tuesday, KQED's "California Report" reported on Medi-Cal beneficiaries' shift to managed health care plans (Varney, "California Report," KQED, 5/31).