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AB 1296 Stakeholder Meeting. Transfer of Coverage. Transfer of Coverage. Transfer of coverage between Medi-Cal and Covered California.

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transfer of coverage
Transfer of Coverage

Transfer of Coverage

Transfer of coverage between Medi-Cal and Covered California

  • DHCS and Covered California are reviewing processes for transferring individuals between programs when a beneficiary loses coverage in their existing program.
    • We want to look at the various ways to transition individuals between the two programs without adversely effecting the beneficiary to the extent possible.
    • We want to ensure we make the best use of the technology available so that the two programs can seamlessly share data back and forth.
    • We would like to solicit stakeholder feedback on these processes as they are developed.
calheers report
CalHEERS Report
  • Verifications
  • NOAs
  • eHIT, Add a person, Renewals
  • Foster Youth, Immigrants
  • Projected Income
  • Known Defects
  • RIDP
calheers functionality
CalHEERS Functionality
  • Several major areas of functionality will be deployed through June 2014
slide6

DHCS Report

  • Medi-Cal Health Plan Selection
    • Roadmap for Implementation
    • Medi-Cal Health Plan Selection Functionality in CalHEERS
    • County and Certified Enrollment Counselor Training
medi cal health plan selection
Medi-Cal Health Plan Selection

Core Function to be included in Release 4.3:

  • Selection of Subplans, PCP, IPA
  • Display correct TLIHP plan cost
  • Allow pending applicants to choose plan
  • Redesign Medi-Cal Plan choice display: a) suppress cost-sharing information, b) show information about what services are currently offered and covered, c) provide information about carve-outs or what is not covered by the plan
medi cal health plan selection1
Medi-Cal Health Plan Selection

Plan Enrollment for 1 Member

medi cal health plan selection4
Medi-Cal Health Plan Selection

Enrollment Summary: Combined Medical and Dental

certified enrollment counselor training modules1
Certified Enrollment Counselor Training Modules

CEC training on Plan Selection:

open forum
Open Forum

Additional

questions, comments, or requests?

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