The Cal MediConnect Program is a significant advancement in the nation’s healthcare system, assisting the nation’s poorest citizens qualified for both Medicare and Medi-Cal (dual eligible members). This optional program combines the current system’s overlapping properties.
The California Department of Health Care Services (DHCS), in collaboration with the federal Centers for Medicare & Medicaid Services (CMS), is directly contracting with L.A. Care Health Plan, Health Net, CareMore, Blue Shield of California Promise Health Plan, and Molina Healthcare for the Cal MediConnect program in Los Angeles County, to make the process of ensuring every citizen seamless. Cal MediConnect got launched in April 2014 as a voluntary enrollment program in Los Angeles County.
Here’s the complete guide to Cal MediConnect.
In what ways does the Cal MediConnect initiative improve health care?
Cal MediConnect’s mission is to improve health care and assist members in remaining in their homes and communities for extended periods. Over three months, the procedure is subjected to many checks and balances to ensure that receivers are their choices. A streamlined will get experienced by both members and healthcare providers: one benefit package, one responsible and accountable health plan, and one payer. All Medicare and Medi-Cal benefits will get coordinated under one health plan, Cal MediConnect:
- Medical Assistance
- Medications on Prescription
- Care for Mental and Behavioral Health
- Services & Supports for the Long Term (LTSS)
- Access to Social Services (like meal delivery)
Benefits and services of Cal MediConnect
Cal MediConnect combines all of your Medicare and Medi-Cal benefits into a single health plan. Medicines, equipment, and supplies are all included. Care coordination, transportation, and vision care are all included in Cal MediConnect programs. Extra perks are available with some plans.
- It’s straightforward to get medical attention.
You need to call one number if you have questions or require assistance. You need one card—your Cal MediConnect card—to receive services.
- Medicines, equipment, and supplies
All of your prescriptions, medical supplies, and equipment will get covered by Cal MediConnect. If something you require but isn’t receiving, inform the plan.
- Dental coverage
Extra dental services are available with some plans. Inquire about the plan’s dental coverage.
- Benefits that can get chosen
Some plans include innovative features that make it simpler to live independently, such as in-home wheelchair ramps or grab bars in the shower. Tell your strategy what you require.
- You can hire a Care Coordinator on your own.
Your plan may assign or request a personal Care Coordinator for you. That is a medical professional, such as a nurse or a doctor. To assist you in preserving your health, he will coordinate the work of your doctors, pharmacists, and other healthcare providers. You can organize your care with the support of your Care Coordinator. You can invite family or friends if you want to. Your Care Coordinator will also perform the following tasks:
- Ask you what you require and try to assist you in obtaining it.
- Be accessible to take your calls and answer your inquiries.
- Make arrangements for any services you may require to help you live independently (such as meal delivery and personal care assistance).
- Assist you with scheduling appointments, arranging transportation, obtaining authorizations, and monitoring your medicines.
- Assist you in locating the appropriate service providers.
To join Health Net Cal MediConnect, you must:
- You must be a resident of the Health Net Cal MediConnect service area (Los Angeles and San Diego counties).
- You must be at least 21 years old.
- Have complete Medi-Cal coverage, as well as
- You must get registered in Medicare Parts A and B.
- You must be eligible for Part D.
- There will be no cost-sharing.
- Alternatively, if you have a cost-share, you must
- Be a resident of a Medi-Cal-funded nursing home, or
- Take advantage of In-Home Supportive Services (IHSS)
Cal MediConnect is a program that helps people Medicare and Medi-Cal qualified. Cal MediConnect is a comprehensive health plan that covers medical, prescription pharmaceuticals, and long-term services and supports.
These services can help you stay at home or in a nearby care center if you have a significant health condition. That provides many people with the opportunity to improve their quality of life.