Things to Know About Health Insurance and Medi-Cal

Redetermination, Open Enrollment and Medi-Cal Expansion... Oh My!

Understanding health insurance can be tricky- especially with so many changes happening. We hope this newsletter helps you to understand the different resources available to families to help them navigate applying for, and continuing to receive, Medi-Cal, Partnership, and plans through Covered California.

If you don't read the whole newsletter, here are some key points and reminders:

  • Starting January 1, 2024, a new law expands complete Medi-Cal coverage to all individuals aged 26 through 49 who meet income requirements, regardless of their immigration status.

  • Starting January 1, 2024, most Medi-Cal recipients in Sonoma County will receive their insurance through Parntership Health Plan.

  • If your client receives paperwork from the State to renew their Medi-Cal, encourage them to complete it! The state is doing redeterminations now and if they do not provide requested information they may lose their coverage. Status of benefits can be checked here:

  • Pregnancy/Post-partum Medi-Cal coverage extends through the full 12 months postpartum (this law was implemented in April 2022 but there continues to be confusion!)

Open Enrollment is November 1, 2023

through January 31, 2024

Anyone in need of health insurance can learn about different plans available in Sonoma County, including Medi-Cal, and how to apply by visiting the Covered California website. There is one application for all plans. When someone applies, they will find out which plans they are eligible for, including Medi-Cal, and whether or not they are eligible to receive financial help to pay for insurance.

We know that some individuals have a tough time navigating websites. Aliados Health has a list of enrollment counselors listed here. Those in need of extra help can call to schedule an appointment. Enrollment counselors work in health centers throughout the county.

Medi-Cal Redetermination

California has resumed doing "redeterminations" for individuals who have Medi-Cal. This means that they are sending out forms asking for updated contact information, income, and other information to make sure that someone is still eligible to receive Medi-Cal. It is very important that individuals and families are encouraged to complete these forms- if they don't, they may lose their coverage.

California has information on how to make sure to keep coverage here.

The Sonoma County Economic Assistance Division houses our County Medi-Cal program. If there are questions about renewing or updating information to keep Medi-Cal coverage, call them at (877) 699-6868.

Upcoming Medi-Cal Coverage Expansion: January 2024

Great News!!! Starting January 1, 2024, all individuals aged 26 to 49 will be eligible to receive Full Scope Medi-Cal, regardless of their immigration status!! This expansion follows previous expansions for young adults (18-25) and older adults (50 and over). You can read more about this expansion in Medi-Cal services here.

We know that use of public services like Medi-Cal can cause fears related to the public charge laws. Here is what the State says about the new Medi-Cal expansion and public charge: "The U.S. Department of Homeland Security and U.S. Citizenship and Immigration Services do NOT consider receipt of health, food, and housing benefits as part of the public charge determination. Therefore, using Medi-Cal benefits (except for residential nursing home or mental health institution care) will NOT hurt an individual's immigration status. " More information about public charge can be found in English here and in Spanish here.

Partnership Health Plan and Cal AIM Services

Most people in Sonoma County who have Medi-Cal will have their Medi-Cal provided to them through Partnership Health Plan starting in January, 2024. Questions about services for Partnership Health Plan members should be directed to their Member's Services number:

Partnership has a list of Sonoma County resouces for families listed here.

Partnership also has a programs through the Cal AIM funding from California- these are supports and services designed to help the most vulnerable families. These include Enhanced Care Management (ECM) and Community Supports services. You can read more about these programs here:

Dont' Forget- we have many resources and information around accessing health insurance on our MCAH Website! Check it out here!

We hope you have a wonderful Holiday!

Sonoma County MCAH
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