Important 2024 changes to Medi-Cal Coverage

3 Important Updates About Medi-Cal Coverage

Medi-Cal Managed Care Plans   |   Restricted Medi-Cal   |   Medi-Cal Dental Coverage

 

 

Update #1 – Medi-Cal Managed Care Plans:

Effective 01/01/2024, Managed Care plans will be updated. Certain Medi-Cal members in 21 counties may be required to switch to a new health plan on January 1, 2024. To see the updates for your county, please refer to the list below.

– If your current plan is no longer available in your county, please check Health Care Options or schedule an appointment with our Eligibility Team to select a new Managed Care plan.

– If you are from Sacramento County, you may fill out the Medi-Cal Choice Form for Sacramento County

– If your county is not included in the list below, please visit the following link to review the updates in your area: Home | Managed Care Plan Transition | DHCS

 

Communications & Outreach Efforts:

Multiple letters have been sent to individuals who may be impacted by changes to their benefits by the Department of Human Assistance. If you have not received a letter, it’s possible that your information needs to be updated in the state system. To update your information, you have several options:

  • Contact your local county office by visiting the County office’s website. County Offices (ca.gov)
  • Log in to the Medi-Cal portal at Together, we benefit.
  • Schedule an appointment with a One Community Health Insurance Eligibility & Enrollment Specialist at the following location: One Community Health 1500 21st Street Sacramento, CA 95811, or call (916) 443-3299

 

Updates by County:

  • Sacramento County
    • AETNA Medi-Cal will no longer be offered. If you have Aetna, you can select a new plan by 12/22/2023 or one will be chosen for you.
    • Available options include Kaiser and Partnership.
  • Placer County
    • ANTHEM Medi-Cal will no longer be offered. If you currently have Anthem, you can select a new plan by 12/22/2023, or one will be chosen for you. If you are eligible for an exemption, remove the Managed Care plan and switch to straight Medi-Cal by submitting the form to your provider. Download Forms | Medi-Cal Managed Care Health Care Options
    • Partnership Medi-Cal patients in the Ryan White Program can come to One Community Health for specialty services only.
    • Available Options: Kaiser and Partnership.
  • Yolo County
    • One Community Health is not contracted with the available Managed Care plan options. However, some patients may qualify for an Exemption that allows them to switch to straight Medi-Cal and remove the Managed Care plan. To avail of this option, you need to provide the form available for download at Download Forms | Medi-Cal Managed Care Health Care Options to your healthcare provider.
    • Patients who currently have Partnership Medi-Cal and participate in the Ryan White Program may continue receiving only specialty services at One Community Health.
    • Available Options: Kaiser and Partnership.
  • El Dorado County
    • California Health & Wellness Medi-Cal will no longer be offered. One Community Health is not contracted with the available options. If you have CA Health & Wellness Medi-Cal, you can select a new plan by 12/22/2023, or one will be chosen for you.
    • You may qualify for an exemption to switch to straight Medi-Cal. Download this form from the Medi-Cal Managed Care Health Care Options website and provide the form to your provider. Partnership Medi-Cal patients in the Ryan White Program can continue to visit One Community Health for specialty services only.
    • Available Options: Kaiser, Mountain Valley, and Partnership.

 

Update #2 – Restricted Medi-Cal:

Effective 01/01/2024, Restricted Medi-Cal will be replaced with FULL SCOPE/Full Coverage Medi-Cal. This transition will apply to all patients with restricted Medi-Cal, regardless of age or immigration status. Medi-Cal providers will be able to offer Full Scope Medi-Cal to adults aged 26 through 49.

For more information, visit: Ages 26 through 49 Adult Full Scope Medi-Cal Expansion | Medi-Cal Providers

Restricted Medi-Cal is a type of health care coverage that offers limited services to low-income residents of California who do not qualify for full-scope Medi-Cal or CMSP benefits due to their immigration or citizenship status. This coverage includes emergency and pregnancy-related care.

What this means for you: You’ll have full coverage for other health services such as medical, dental, behavioral health, vision, natural medicine, medication costs, labs, referrals, and hospital visits.

 

Communications & Outreach:
You will be sent a letter indicating your Medi-Cal start date. Please contact your provider/pharmacy to update your coverage information. If you have not received a letter, your information may need to be updated in the state system. To update your information, you have several options:

  • Contact your local county office by visiting the County office’s website. County Offices (ca.gov)
  • Log in to the Medi-Cal portal at Together, we benefit.
  • Schedule an appointment with a One Community Health Insurance Eligibility & Enrollment Specialist at the following location: One Community Health 1500 21st Street Sacramento, CA 95811 or call (916) 443-3299

 

If you would like to learn more regarding your new coverage or need assistance with the documentation sent to you:
Schedule an appointment with a One Community Health Insurance Eligibility & Enrollment Specialist at (916) 443-3299. We are excited to discuss this upcoming change and what it means for you.

 

Update #3 – Medi-Cal DENTAL:

Health Net Medi-Cal and Liberty Medi-Cal will no longer be available as viable options for Medi-Cal patients seeking dental coverage. Your plan will remain unchanged if you already have Health Net or Liberty coverage. However, if you are a new patient or looking to switch your plan, you will be offered Denti-Cal as an alternative option.

One Community Health will continue to accept patients who are covered by Denti-Cal, Health Net, and Liberty Medi-Cal. This means that there will no longer be a requirement for a dental Managed Care plan.

If you have any questions about this change, please don’t hesitate to contact One Community Health’s Care Dental Coordinators at the following address: 1500 21st Street, Sacramento, CA 95811, or by calling (916) 443-3299.

 

Recent News