The Latest News from CalOptima

Community Connections

October 20, 2021

In This Issue

This issue focuses on breast health and resources available to people affected by breast cancer. Read about the mammogram incentive program offered to eligible CalOptima members and the state’s Breast and Cervical Cancer Treatment Program. Learn about Cancer Kinship and the services that are offered through this nonprofit organization. Also learn about the DHCS's Vaccination Incentive Program and CalOptima’s participation, California Health and Human Services Agency’s COVID-19 Vaccine Action Plan and tips to prevent the flu during the ongoing COVID- 19 pandemic.

The Latest News from CalOptima

October Is National Breast Cancer Awareness Month

Doctor Hands Holding Pink Cancer Awareness Ribbon

Breast cancer is one of the most common cancers found in U.S. women. Women are at higher risk for getting breast cancer as they get older. While rare, men can also get breast cancer. The good news is that the risk of getting breast cancer can be lowered by keeping a healthy weight, eating fruits and vegetables, staying active and drinking less alcohol.

Individuals can take steps to lower the risk of getting breast cancer and find it early when it may be easier to treat. One step is to know how their breasts normally look and feel. By doing monthly breast self-exams, changes to an individual's breasts, such as a lump, can be found early and should be shared with the doctor right away.

For some, breast cancer starts with no symptoms at all. That is why getting a mammogram — an X-ray of the breast to screen for breast cancer — is so important. For most women, it is recommended to talk to a doctor about getting a mammogram starting at age 40 to screen for breast cancer. No-cost mammograms are a preventive care service covered by CalOptima.

Did you know CalOptima offers eligible members ages 50 to 74 a no-cost $25 health reward gift card for completing a screening mammogram? Visit www.caloptima.org/healthrewards to view or print current incentive forms.

What is the Breast and Cervical Cancer Treatment Program?

The Breast and Cervical Cancer Treatment Program (BCCTP) provides cancer treatment and services for eligible low-income California residents through the state’s Medi-Cal program. Both women and men are screened by Cancer Detection Program: Every Woman Counts (CDP: EPC) or the Family Planning, Access, Care and Treatment (Family PACT) programs. People who need additional screening or treatment for breast or cervical cancer may be eligible.

What benefits are available through BCCTP?

BCCTP provides coverage for breast and cervical cancer treatment and services related to limited cancer diagnoses. If approved for federal BCCTP, members may receive full scope Medi-Cal coverage, which is not limited to breast and cervical cancer treatment.
State-funded BCCTP provides no-cost services limited to breast and cervical cancer treatment and related services.
Most members who qualify for enrollment with CalOptima under BCCTP will be enrolled in the CalOptima Community Network and have access to care coordination through a nurse case manager.

State Program Provides Cancer Screening, Treatment

The Breast and Cervical Cancer Treatment Program (BCCTP) provides cancer treatment and services for eligible low-income California residents screened by one of two programs:

The Cancer Detection Program: Every Woman Counts (CDP: EWC)
The Family Planning, Access, Care and Treatment (Family PACT) program

Click here for the full article on state and federal eligibility for the BCCTP.

Partner Highlight: Cancer Kinship

Breast Cancer Awareness Month serves as a reminder that when it comes to fighting cancer, it’s a battle no one should ever fight alone. It’s also a reminder that we can all take an active role in preventing and reducing cancer risks, including cancer recurrence risks. Cancer Kinship offers programs and services to help the cancer community brave the storm, confidently and fearlessly by engaging in activities that promote healthy living and address the emotional impact of the disease.

Click here to learn about Cancer Kinship's Programs.

Group of Multiethnic Women Wear Pink Shirt

CalOptima Participates in DHCS's Vaccination Incentive Program

To improve health equity and reduce disparities in vaccine distribution and uptake for Medi-Cal members, CalOptima has elected to participate in the Department of Health Care Service’s (DHCS) voluntary COVID-19 Vaccination Incentive Program.

Covering all members who are not fully vaccinated against COVID-19, the program allocates up to a total of $350 million statewide to incentivize managed care plans’ (MCP) vaccination and outreach efforts between September 1, 2021, through February 28, 2022. Per the program’s guidelines, an MCP is eligible to earn incentive payments by developing a Vaccination Response Plan and meeting specific outcomes to improve vaccine access and close vaccination gaps for members.

CalOptima’s participation in the DHCS program will help propel its vaccination efforts, including member health rewards program, member texting program and other strategies, to target members in harder to reach populations. It will also help the agency explore new ways of reaching members and coordinate with partners to ensure all members have equitable access to vaccines.

To learn more about the DHCS Vaccination Incentive Program, click here.

California Health and Human Services Agency Releases COVID-19 Vaccine Action Plan

Following the authorization of Pfizer-BioNTech COVID-19 vaccine boosters for those age 65 and older and high-risk individuals, the California Health and Human Services Agency (CDPH) released a COVID-19 Vaccine Action Plan on Thursday, September 23.

The plan outlines how the state will be able to administer booster doses to eligible Californians, as well as continue an equity-centered focus on eligible but unvaccinated individuals and expand operations once more Californians are eligible. It also outlines scenarios to ensure the state and partners can meet expected demand for boosters and are ready to administer vaccines to Californians under age 12, once authorized.

In anticipation of the state’s Vaccine Action Plan, CalOptima is prepared to leverage its vaccination efforts, such as its member health rewards and member texting programs, as well as mobile vaccine clinics in collaboration with the County of Orange, to close vaccination and equity gaps in the Orange County community. These efforts have resulted in more than 404,000 CalOptima members getting vaccinated to date.

To view the CDPH Vaccine Action Plan, click here.

Tips to Prevent the Flu During the COVID-19 Pandemic

Influenza — also known as the flu — is a serious illness. Some of the symptoms of the flu and COVID-19 are similar, making it hard to tell the difference between them based on symptoms alone. People with chronic conditions are at a higher risk of having serious health problems from the flu.

Today, the flu shot remains more important than ever to help you, your family and your community stay healthy and prevent severe illness. The flu shot cannot give someone the flu, and it is considered safe. Getting the flu shot and COVID-19 vaccine has been shown to lower the chances of hospital admissions. CalOptima members can get the flu shot at no cost.

You can get a COVID-19 vaccine and a flu vaccine at the same time, according to the Centers for Disease Control and Prevention (CDC). The CDC also states that everyone 6 months and older should get a flu shot. If you have questions or concerns about the flu or COVID-19 vaccines, talk to your doctor or a pharmacist to learn what health actions are right for you.

Click here for tips to help prevent the spread of the flu and COVID-19.

How to Contact CalOptima During the COVID-19 Pandemic

CalOptima Customer Service remains ready to respond to member needs. Members can call Customer Service from the safety of their home, 24 hours a day, 7 days a week. We have staff who speak their language.

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