A dual eligible patient who does not enroll in cal mediconnect will continue to receive their medicare services as they do currently, through either a medicare advantage plan or traditional medicare feeforservice, but most medi cal benefits will be now administered by a medi cal health plan. Iehps provider portal is equipped with resources to equip all of our providers with easy to use tools. Cares cal mediconnect plan offers complete health coverage, including personal help when you need it at no extra cost. The contractor must maintain books, records, documents, and other. Cal mediconnect january 2015 enrollment faq health net. The plan choice form is located in the middle of the plan choice book. Using this manual designed for physicians, hospitals, long term services and supports ltss providers and ancillary providers who are participating in the anthem blue cross cal mediconnect plan, this manual is a useful reference guide for you a nd your office staff. Iehp dualchoice cal mediconnect plan medicaremedicaid plan is a health plan that contract with both medicare and medi cal to provide benefits of both programs to enrollees. Only other government agencies that relate to the medi cal program can see the information you provide. Nocost, integrated health plan for people with both medicare and medi cal. Combine my medicare and medical benefits in one plan. Cal mediconnect plan also, contractor a health plan or other qualified entity jointly. Cal mediconnect plan or by allowing the state to enroll me in a cal mediconnect plan, i agree to the following.
What you should know about cal mediconnect plans cal mediconnect is a program to serve people that are eligible for both medicare and medi cal. Updates received from our network providers are generally added to the find a provider or hospital search tool once a week. An individual can participate in the program by choosing a participating cal mediconnect health plan. Employees can go directly to our broad ppo network of doctors and hospitals. Iehp dualchoice 2020 plan benefits ncd how to access care grievances, coverage determination and appeals process. We need to know your choice just in case you do not qualify to join pace. Iehp dualchoice cal mediconnect plan medicaremedicaid plan. Mediconnect and choose a different medicare advantage plan or medicare. Iehp dualchoice cal mediconnect plan medicaremedicaid plan nocost, integrated health plan for people with both medicare and medi cal. These enrollees may also receive a letter from their dsnp plan letting them know that they.
We will send you a notice before we make change that affects you. Nocost, integrated health plan for people with both medicare and medical. Box 989009 west sacramento, ca 957989850 18445807272 tty. If any information asked for on the choice form is missing, then someone on the form may not be able to join a health plan, get out of a plan, or choose the plan he or she wants. The cal mediconnect program is an important innovation in the nations health care system to help out the nations most low income individuals, those who qualify for both medicare and medical dual eligible members. The new cal mediconnect and mltss resource guide and choice book has completed the university of californias beneficiary user testing process and is being finalized. Use the health plan guidebook and choice book that will come in the mail from health care options to help you. You will get all your medicare part a, part b and part d benefits and your medical benefits, including long term services and supports, through a plan of your choice. Now is the time to learn about these changes and how they will benefit your patients. Complete the choice form found in this book and mail it in. Our goal is to provide our members with quality care delivered in the right setting at the right time. Blue shield of california promise health plan is a managed care organization, wholly owned by blue shield of california, offering medi cal, cal mediconnect, medicare advantage hmo, and dual eligible special needs plans dsnp. Beneficiaries can choose not to participate in cal mediconnect.
If you do not make a choice, we will choose a medical managed care plan for you. Iehp is committed to keeping our providers informed with the latest information. Cal mediconnect plans are medicaremedicaid plans that have a contract with the state of california and the federal government. Iehp dualchoice cal mediconnect plan earns top customer satisfaction score in the nation. All of the patients medi cal and medicare benefits will be administered by the one health plan of their choice, which will better streamline and coordinate services and benefits. You can choose one of these cal mediconnect plans under option a on the plan choice form. Enclosed in this choice book is your health plan enrollment choice form, please complete and return the choice form by state of californiahealth and human services agency department of health care services p. This information is also subject to change at any time. If you choose to stay with regular medicare, you must choose a medi cal health plan for your medi cal. I will need to keep my medicare parts a and b and medical. Care cal mediconnect provider manual in coordination with the centers for medicare and medicaid services cms, the department of.
You can view quality reports about medi cal and health plans on the quality reporting page. Get both your medicare and medical benefits in one plan. Learn more about iehps incentive programs offered to qualified practitioners, including traditional p4p and global quality p4p. Cal mediconnect is a new choice that will combine all of the medicare and medical benefits and services you receive now into a single plan. Health plan choice form health care services california. Cal mediconnect health plans point of contact lists. We are committed to providing health care that is medically excellent, ethicallydriven, and delivered in a patient. Health net communitycare choice plus plans are available. Cal mediconnect plan quick reference guide caremore health. Medi cal, medicare advantage, hmo, pos, hsp, ppo,epo, and products offered through covered california.
If certain criteria is met, a cal mediconnect plan must allow a beneficiary the right to maintain his or her current outofnetwork providers and service authorizations at the time of enrollment for a period of. Nocost or lowcost health care coverage for lowincome adults, families with children, seniors, and people with disabilities. This form is in your choice book that will come in the mail from health care options. For more information contact the plan or read the healt. Medi cal and every health plan must offer quality good health care to help you stay healthy. Cal mediconnect plan, or choose to stay with regular medicare.
Iehp medi cal member services 800 4404347 800 7184347 tty iehp dualchoice member services 877 2734347 800 7184347 tty iehp 24hour nurse advice line for iehp members only. Dhcs anticipates ongoing mandatory enrollment of mltsseligible beneficiaries into mltss plans will begin in fall 2016. Awardwinning cultural and linguistic program health net is the only cal mediconnect plan to receive the multicultural health care distinction from the national committee for quality assurance. Ask your doctors and other health care providers to see. This county is called a county organized health system cohs and has only one cal mediconnect plan serving the county. Santa clara county is the service area for the cal mediconnect plan. Onecare connect cal mediconnect plan medicaremedicaid plan for people who qualify for both medicare and medical, combining medicare and medical benefits, adding supplemental benefits for vision, transportation and dental services, and providing comprehensive care coordination better. You can choose a plan that fits your needs at any time before xxxxxxxx. A voluntary, program designed to coordinate medical, mental health and behavioral health, and longterm services and supports ltss under one plan for members eligible for both medicare and medi cal. Visit our mobilefriendly page for a better viewing experience.
If you want to choose a different cal mediconnect plan or choose a medi cal plan, please fill out the health plan choice form in this choice book. However, you must still choose a cal mediconnect plan or a medical health plan. Longterm services and supports mltss resource guide and choice book. Combine all the medicare and medical services you get now into a single health plan. You do not need a stamp if you use the enclosed envelope. Cal mediconnect is an allinone health plan that covers medical, prescription drugs medicines and longterm services and supports. Cal mediconnect plans these plans cover both medicare and medical. Need help finding a health net cal mediconnect plan doctor or pharmacy. It no longer matters where you are from or what language you speak. How to enroll to choose a plan or optout of cal mediconnect you can. How to choose a plan jenna macrae attorney, registered hicap counselor.
Dhcs will also soon be finalizing a physician toolkit to help physicians and their patients understand the project. Evaluation of cal mediconnect the scan foundation ltss summit october 27, 2015 uc san francisco community living policy center and institute for health and aging uc berkeley school of public health, health research for action. The beneficiary perspective carrie graham, phd, mgs. Sign and date your completed health plan choice form use the envelope in this health plan choice book to mail your completed health plan choice form. Cal mediconnect plan will work with your doctors and. Please read the important information on the back of the health plan choice form before signing and mailing the choice form. You can choose a cal mediconnect plan, which covers all of your current medicare and medical. Cal mediconnect and medical resources for advocates.
Cal mediconnect plans these plans cover both medicare and medical long term services and supports. Plan for ltss elect to not participate in cal mediconnect. You have many health plans to choose from to receive your medical benefits. The toolkit has been developed in conjunction with harbage consulting and various stakeholder groups. This guide will help you understand your plan choices, what benefits are available within. Health net life insurance companys ppo insurance plans are a perfect fit for groups that want to offer their employees choice and flexibility. The list of covered drugs andor pharmacy and provider networks may change throughout the year. Iehp dualchoice cal mediconnect plan earns top customer. Use this guide to help you choose which type of cal mediconnect plan is best for you. Contact us by phone or submit a general question below. The cal mediconnect program brings changes to the california health care system. This voluntary program consolidates the overlapping properties of the present system. The benefit information is a brief summary, not a complete description of benefits. Care connections enewsletter will be your source for.