How State Will Handle Medi-Cal Renewals

Before the expansion of Medi-Cal, roughly eight million Californians were enrolled in the program. Every Medi-Cal beneficiary needs to renew coverage annually — but so far, only about half of those people have rejoined Medi-Cal.

That leaves about four million Californians who still need “redetermination” of their Medi-Cal status this year. They have to renew within 90 days after their state coverage lapses. 

According to Carol Sloan, information officer at the Department of Health Care Services, the department is committed to re-enrolling as many of those people as possible.

“DHCS is working with the counties and partners on a concerted effort to help ensure that renewal forms are returned within the required timeframes,” Sloan said in a written statement.

In fact, she said, the rate of returns on renewal forms, so far, has been similar to previous years.

“Return rates are reaching levels that are consistent with those reached prior to implementation of the Affordable Care Act, greater than 70%,” Sloan said.

The state wants to recapture as many enrollees as it can — so for now, the state has delayed cancellation of Medi-Cal eligibility for any of those eight million potential re-enrollees, Sloan said.

“The implementation of the ACA was a major change for many beneficiaries in 2014,” Sloan said. “As a result DHCS, in conjunction with county human services agencies and various health plans throughout the state, maintained coverage for beneficiaries beyond the normal annual renewal months to allow the opportunity for additional outreach prior to discontinuing any beneficiaries.”

This year, with the Medi-Cal expansion adding about three million Californians to the program, as well as county workers needing to track down a huge backlog of people with unprocessed applications due to computer issues, the county offices have been swamped with work — and that now includes processing of those eight million renewals.

DHCS officials estimate about four million completed renewals from June through September 2014.

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Capitol Desk Medi-Cal