Cal MediConnect Plans Ending
Cal MediConnect health plans will end on December 31, 2022. On January 1, 2023, members enrolled in L.A. Care Cal MediConnect (Medicare-Medicaid Plan) will automatically transition to L.A. Care Medicare Plus (HMO D-SNP).
L.A. Care Medicare Plus provides an integrated approach to coordinated care for our dual eligible members with a dedicated care team that works in coordination with our members and their providers to ensure all the member's health needs are met. Below you will find answers to frequently asked questions regarding the transition from L.A. Care Cal MediConnect to the new L.A. Care Medicare Plus plan.
On January 1, 2023, current L.A. Care Cal MediConnect members will be automatically enrolled into L.A. Care Medicare Plus our new HMO Dual Eligible Special Needs Plan. You will not have a gap in your coverage or in the care you are currently receiving. Members will get all their services through Cal MediConnect until December 31, 2022.
On January 1, 2023, members will automatically begin to get services through L.A. Care Medicare Plus. You do NOT need to do anything to enroll into the L.A. Care Medicare Plus plan. You will receive additional notices by mail 90 and 45 days prior to transitioning to your new plan.
The following Medi-Cal covered services are not impacted by this change:
- In-Home Support Services or providers
- County specialty mental health and substance use disorder services or providers
- Multi-Purpose Senior Services Program services or providers
- Medi-Cal Covered Rx Services
- Medi-Cal Dental Services
- Home and Community-Based Waiver Services or providers
Members will continue to receive these services from the same providers they do today without interruption.
In October 2022, L.A. Care Cal MediConnect members will begin receiving communications about the transition to L.A. Care Medicare Plus. The transition will be coordinated by the Centers for Medicare & Medicaid Services, Department of Health Care Services and L.A. Care Cal MediConnect Plan.
Members in L.A. Care Cal MediConnect today do NOT need to do anything to enroll into L.A. Care Medicare Plus.
Current L.A. Care Cal MediConnect members will continue to get services from the plan until December 31, 2022. On January 1, 2023, members will automatically start getting services through L.A. Care Medicare Plus.
L.A. Care Medicare Plus will cover many of the Medicare and Medi-Cal benefits you get now, including:
- All Medicare covered services, including doctors, hospitals, labs, and x-rays
- You will have access to a provider network that includes many of the same providers as your current plan
- Prescription drugs covered by Medicare
- Coordination of the services you get now or that you might need
- Transportation to medical services
- Medical supplies
- Durable Medical Equipment (DME)
- Nursing home care
- Community-Based Adult Services (CBAS)
- Over-The Counter Items
- Gym Membership
- In-Home Support Services
- Personal emergency response systems (PERS)
- Healthy Foods and Utility / Gas Flex Card (This benefit is part of a special supplemental program for the chronically ill. Not all members qualify. Please refer to Chapter 4 of the Member Handbook.)
- Acupuncture, Chiropractic and Therapeutic Massage (Routine)
You will have access to a provider network that includes many of the same providers as your current plan to ensure continuity of care for members.
If you are new to L.A. Care and are in an active service treatment plan or are receiving services from a provider who is not in L.A. Care’s network, you may be able to keep your doctor for a limited period of time, this is called Continuity of Care.
To qualify for Continuity of Care (COC):
- You must have seen the Primary Care Physician (PCP) and/or Specialist at least once during the last 12 months, and have an upcoming appointment with the PCP or Specialist within the next 12 months.
- Your Provider must be willing to accept the L.A. Care Health Plan rates and contract with the appropriate Medical Group/IPA.
In the month of December 2022, L.A. Care Medicare Plus will send members a new member ID card and Welcome Kit.
Your kit will include:
- A welcome letter
- A Summary of Medicare and Medi-Cal benefits
- Instructions to get the list of covered drugs online or to ask for a hard copy
- Instructions to get the provider and pharmacy directory online or to ask for a hard copy
- Instructions to get Member Handbook online or to ask for a hard copy.
- Health Risk Assessment (HRA) form
If you have questions about the Cal MediConnect to L.A. Care Medicare Plus transition and wish to speak to a representative, please call us at 1-833-LAC-DSNP (1-833-522-3767) (TTY 711). We are happy to assist you 24 hours a day, seven days a week including holidays.