Affordable Care Act
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Medi-Cal households to receive 1095-B letter
Starting this week, DHCS is sending Medi-Cal beneficiaries information about the 1095-B that households will need to show minimum essential coverage for the year at tax filing. The 1095-B forms themselves will be mailed out no later than…
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Counties may continue accepting older Medi-Cal applications
According to state law, counties are supposed to stop accepting older, non-single streamlined applications for Medi-Cal after January 1, 2016. However, DHCS is requiring counties to continue to accept these older applications (including the SAWS 2 PLUS) and…
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Notices for 1095-B at Initial Medi-Cal Application
Counties must offer a 1095-B beneficiary notice to all households at application for insurance affordability programs including Medi-Cal. The Notice will provide information about the Form 1095-B and remind all applicants to report all changes that may affect…
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Counties must review Share of Cost cases for MAGI eligibility
The State issued an urgent reminder to counties to review caseloads for share of cost cases (or potential share of cost cases denied due to assets) for MAGI eligibility. These cases should be appropriately determined back to January…
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Medi-Cal Benefits for Students Attending College Out of County
When a student attends college in a different county, the family needs to inform the county of this change. The county will update only the student’s address in SAWS and MEDS. This change will trigger change in health…
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Medi-Cal Discontinuance Notices for Overincome, Ineligible Beneficiaries
DHCS is clarifying NOA issuing requirements for Medi-Cal discontinuances when the beneficiary is over income for MAGI, not eligible for consumer protection programs, and has no potential non-MAGI eligibility. Counties must issue a timely and adequate manual discontinuance…
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Change to Eligibility Period for Presumptive Eligibility (PE) Medi-Cal
As of December 31, 2014, PE coverage begins on the date of the eligibility determination and ends at the end of the following month if no Medi-Cal application is submitted for full determination. Previously, presumptive eligibility went back…
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Making Changes to Beneficiary Information with a Health Plan
Managed care plans are to contact county office liaisons to provide updated contact information for Medi-Cal beneficiaries. If the plan has received the beneficiary’s approval, the counties must incorporate these changes immediately. If the plan does not have…
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Medi-Cal backlog cases no longer batched for Accelerated Enrollment
DHCS has explained that the application batching process that allowed the state to mitigate some of the 2014 application backlog through Accelerated Enrollment (AE) has ended. DHCS is still required to send Rivera Notices of Inaction when an…
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Fixing Medi-Cal Aid Codes for Former Foster Youth
DHCS issued instructions to the counties to facilitate the appropriate Medi-Cal coverage of former foster youth through aid code 4M. Former foster youth are entitled to receive Medi-Cal through the age of 26. The current CalHEERS programming uses…