Information for Beneficiaries
On January 1, 2023, your Cal MediConnect plan will change into matching Medicare and Medi-Cal plans provided by the same company that provides your Cal MediConnect. These matching plans are designed to coordinate care for people with both Medicare and Medi-Cal. You will still get the same health care benefits as you do today.
You will get all your services through Cal MediConnect until December 31, 2022. Then on January 1, 2023, you will automatically start getting services through your matching plans instead. If you are in Cal MediConnect today, you do NOT need to do anything to enroll into the matching plans and keep your current benefits.
Your new plans will help you with all your health care needs and will continue to coordinate your benefits and care. This includes medical and home- and community-based services. It also includes medical supplies and medications. The matching plans will include the doctors you see today, or help you find a new doctor that you like.
You will start getting letters about this change in October 2022. You don’t have to do anything this fall to keep getting your health care from the plan you have today. If you have questions about your coverage in 2022, please contact your current Cal MediConnect plan.
Medicare Medi-Cal Aligned Plans
The Cal MediConnect program is transitioning on December 31, 2022. Starting on January 1, 2023, Cal MediConnect members will be transitioned to exclusively aligned enrollment (EAE) Dual Eligible Special Needs Plans (D-SNPs) and matching Medi-Cal Managed Care Plans (MCPs). Under exclusively aligned enrollment, beneficiaries can enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration.
EAE D-SNPs offer an integrated approach to care and care coordination that is like Cal MediConnect. The matching Medicare and Medi-Cal plans will work together to deliver all covered benefits to their members. And as all members in the plan are also enrolled in the matching MCP, they can receive integrated member materials, such as one integrated member ID card.
The transition will happen in all Coordinated Care Initiative (CCI) counties – Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara. Existing Cal MediConnect plans and all Medi-Cal Managed Care Plans in these counties must create EAE D-SNPs by January 1, 2023, to support this transition.
Stakeholders can participate in the D-SNP transition by joining the monthly CalAIM Managed Long-Term Services and Supports and Duals Integration Workgroup, which is open to the public. The workgroup is a collaboration hub where stakeholders can offer feedback to the Department of Health Care Services (DHCS) and engage in discussions related to the policy, operations, and strategy for the D-SNP transition.
For questions about the workgroup, please contact us at firstname.lastname@example.org.
Stakeholders can also participate in county-based Communications Workgroups. Communications Workgroups offer a neutral platform for stakeholders to discuss the Cal MediConnect transition and D-SNP expansion. They are currently offered in six of the CCI counties:
- Los Angeles
- San Diego
- Inland Empire (Riverside & San Bernardino)
- Santa Clara
If you are interested in joining any of the local Communications Workgroups, please email Cassidy Acosta at Cassidy@AurreraHealth.com for more information.
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