CMS Approves DHCS’ Request for a Waiver to Maintain the Continuous Special Election Period for Cal MediConnect

The Centers for Medicare & Medicaid Services (CMS) approved the Department of Health Care Services’ (DHCS) request to waive new Medicare regulations for 2019 that limit the continuous Special Election Periods (SEP) for dual eligible beneficiaries. Under the new regulations, dual eligible beneficiaries are limited to changing Medicare plans just once a quarter for the first three quarters of the plan year, and then may use the Medicare Annual Enrollment Period to select a plan in the last quarter, as always.

Based on stakeholder feedback and internal discussions regarding these new regulations, DHCS submitted a request to waive the new regulations on June 2018 to maintain continuous SEP for Cal MediConnect beneficiaries. The approval of the waiver maintains members’ ability to enroll in, change between, or disenroll from Cal MediConnect without limit on a monthly basis, which is a key beneficiary protection in Cal MediConnect. This does not apply to other Part D plans or Medicare Advantage plans.

The new regulations will go into effect in January 2019, in non-CCI counties and in CCI counties for non-Cal MediConnect plans. For more information, please see our previous blog covering this topic, here.

  1. If a Cal MediConnect beneficiary signs up for a Medicare MAPD plan for their Medicare, leaving their MediCal with Cal MediConnect, are they locked in for the year or can they switch each month?

  2. Felicia Viselli

    Great news for beneficiaries!

Leave a Comment

See All Topics