Iehps provider portal is equipped with resources to equip all of our providers with easy to use tools. The beneficiary perspective carrie graham, phd, mgs. How to choose a plan jenna macrae attorney, registered hicap counselor. Get both your medicare and medical benefits in one plan. Cal mediconnect health plans point of contact lists. Combine my medicare and medical benefits in one plan. You can choose a cal mediconnect plan, which covers all of your current medicare and medical. The cal mediconnect program brings changes to the california health care system. Iehp dualchoice cal mediconnect plan medicaremedicaid plan.
The plan choice form is located in the middle of the plan choice book. Longterm services and supports mltss resource guide and choice book. Care cal mediconnect provider manual in coordination with the centers for medicare and medicaid services cms, the department of. Nocost or lowcost health care coverage for lowincome adults, families with children, seniors, and people with disabilities. Cal mediconnect plan, or choose to stay with regular medicare.
We need to know your choice just in case you do not qualify to join pace. You have many health plans to choose from to receive your medical benefits. Our goal is to provide our members with quality care delivered in the right setting at the right time. Nocost, integrated health plan for people with both medicare and medical. Dhcs anticipates ongoing mandatory enrollment of mltsseligible beneficiaries into mltss plans will begin in fall 2016. Cal mediconnect and medical resources for advocates. This guide will help you understand your plan choices, what benefits are available within. This form is in your choice book that will come in the mail from health care options. 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. Learn more about iehps incentive programs offered to qualified practitioners, including traditional p4p and global quality p4p.
Iehp is committed to keeping our providers informed with the latest information. After we receive your plan choice, you will receive a letter with your chosen health plans name and start date. The toolkit has been developed in conjunction with harbage consulting and various stakeholder groups. Updates received from our network providers are generally added to the find a provider or hospital search tool once a week. Santa clara county is the service area for the cal mediconnect plan. 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. 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.
Cal mediconnect plan or by allowing the state to enroll me in a cal mediconnect plan, i agree to the following. Cal mediconnect plans are medicaremedicaid plans that have a contract with the state of california and the federal government. 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. 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. 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. Ask your doctors and other health care providers to see. Dhcs will also soon be finalizing a physician toolkit to help physicians and their patients understand the project. Choice satisfaction i did not understand it, and what the purpose of participating in the plan. We are committed to providing health care that is medically excellent, ethicallydriven, and delivered in a patient. An individual can participate in the program by choosing a participating cal mediconnect health plan. I will need to keep my medicare parts a and b and medical. 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. Cares cal mediconnect plan offers complete health coverage, including personal help when you need it at no extra cost. Iehp dualchoice 2020 plan benefits ncd how to access care grievances, coverage determination and appeals process.
Beneficiaries can choose not to participate in cal mediconnect. Box 989009 west sacramento, ca 957989850 18445807272 tty. Iehp dualchoice cal mediconnect plan earns top customer satisfaction score in the nation. Cal mediconnect is an allinone health plan that covers medical, prescription drugs medicines and longterm services and supports. Use the health plan guidebook and choice book that will come in the mail from health care options to help you. Need help finding a health net cal mediconnect plan doctor or pharmacy. They must either move into a cal mediconnect plan, or opt out of cal. 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. Plan for ltss elect to not participate in cal mediconnect.
Cal mediconnect january 2015 enrollment faq health net. People with medical in san mateo county do not need to make a choice about which cal mediconnect plan to join. Employees can go directly to our broad ppo network of doctors and hospitals. You can choose one of these cal mediconnect plans under option a on the plan choice form. Health plan choice form health care services california. 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. Cal mediconnect plans these plans cover both medicare and medical long term services and supports. Contact us by phone or submit a general question below.
However, you must still choose a cal mediconnect plan or a medical health plan. Use this guide to help you choose which type of cal mediconnect plan is best for you. The contractor must maintain books, records, documents, and other. 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. Please read the important information on the back of the health plan choice form before signing and mailing the choice form. 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. The list of covered drugs andor pharmacy and provider networks may change throughout the year. Care connections enewsletter will be your source for. 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. Combine all the medicare and medical services you get now into a single health plan. Medi cal, medicare advantage, hmo, pos, hsp, ppo,epo, and products offered through covered california. Cal mediconnect plan will work with your doctors and. For more information contact the plan or read the healt.
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. 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. This information is also subject to change at any time. Health net life insurance companys ppo insurance plans are a perfect fit for groups that want to offer their employees choice and flexibility.
Medi cal and every health plan must offer quality good health care to help you stay healthy. How to enroll to choose a plan or optout of cal mediconnect you can. Only other government agencies that relate to the medi cal program can see the information you provide. 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.
Cal mediconnect plan also, contractor a health plan or other qualified entity jointly. Health net communitycare choice plus plans are available. Now is the time to learn about these changes and how they will benefit your patients. This county is called a county organized health system cohs and has only one cal mediconnect plan serving the county. We will send you a notice before we make change that affects you. If you choose to stay with regular medicare, you must choose a medi cal health plan for your medi cal. Nocost, integrated health plan for people with both medicare and medi cal. Visit our mobilefriendly page for a better viewing experience. If you do not make a choice, we will choose a medical managed care plan for you. Mediconnect and choose a different medicare advantage plan or medicare. This voluntary program consolidates the overlapping properties of the present system. You can view quality reports about medi cal and health plans on the quality reporting page. Iehp dualchoice cal mediconnect plan medicaremedicaid plan nocost, integrated health plan for people with both medicare and medi cal.
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. Cal mediconnect plan quick reference guide caremore health. You can choose a plan that fits your needs at any time before xxxxxxxx. You do not need a stamp if you use the enclosed envelope. Cal mediconnect plans these plans cover both medicare and medical. It no longer matters where you are from or what language you speak. These enrollees may also receive a letter from their dsnp plan letting them know that they.
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. Iehp dualchoice cal mediconnect plan had the thirdhighest score in the country in the 2016 mmp. 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. The benefit information is a brief summary, not a complete description of benefits. 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.