Health

Signing Up for Medical Benefits

Published

9 years ago

May 10, 2015

By Manny Otiko/California Black Media

When LaRita Reed graduated from UCLA, she was excited about earning her degree and all the possibilities that lay ahead. But soon, she found herself facing a new challenge.

The mother of two young children, who had previously been covered under the college’s insurance program, was suddenly uninsured, unemployed and being phased out of her UCLA health care coverage.

Worried mostly about the welfare of her kids, she reached out to her local social services office. While applying for health coverage for her children there, Reed discovered she was eligible for Medi-Cal, a health insurance program for low-income families that she hadn’t heard about before.

With Medi-Cal, her health insurance problem was resolved. But for new applicants to the program, she says, the application process can be confusing.

In addition to doing the research to find out if she was eligible or not, waiting through the four-week approval period was a time of high anxiety.

The California Department of Health Care Services (DHCS) has taken a number of steps to ease the anxiety and uncertainty felt by many Californians like Reed who apply.

Medi-Cal is providing much more information online about the application process, benefits and who gets covered. It is also expanding its reach to cover more people.

A number of health advocacy organizations across the state, like the Root Community Health Center in Oakland, are also helping people to navigate the application process and determine if they are eligible or not.

Adam Weintraub, a spokesman for the California Department of Health Care Services (DHCS), says the most common reason new applicants are rejected is because they make too much money.

Another reason is that applicants may not be able to prove their place of residency.

DHCS says Medi-Cal is now available to low-income families and individuals of all ages who are eligible. Also, the enactment of the federal Affordable Care Act – commonly called “Obamacare” – means more people qualify for Medi-Cal.

To be eligible for the program, families have to make a certain amount of money every year based on poverty levels set by the DCHS and informed by guidelines given by the U.S. Department of Health and Human Services.

Weintraub said that works out to be $32,913 or less in annual income for a family of four. For an individual that number is $16,105 and $21,708 for a family of two.

Having family members with disabilities can also be a factor that helps with Medi-Cal qualification, he added.

Reed says once she was approved, she received a California Medi-Cal card in the mail and she had to choose from three programs: LA Care, Blue Cross or Health Net.

“If you don’t choose, they choose for you,” Reed said. She also advises applicants to do their research before selecting a plan, so they can choose a program that best fits their needs.

Reed says Medi-Cal has been a huge benefit for her because she doesn’t have to pay a monthly premium. If you are employed, Medi-Cal fees are set on a sliding scale based on income.

Reed said another major benefit to Medi-Cal is not having to pay for prescription medications at participating pharmacies. People who are approved are often enrolled in the managed care program, Reed said.

A Medi-Cal Managed Health Care plan offers all the same benefits as a standard Medi-Cal plan. The main difference is that the enrollee in the managed care program is assigned a primary doctor who coordinates care for that patient within a network of doctors to ensure the patient stays healthy.

The plan is designed for patients who are aged, blind, disabled and receiving Social Security Income (SSI) or State Supplementary Payments (SSP) or other state-provided financial assistance.

According to Weintraub, there are some steps applicants can take to speed up the application process. He recommends:

Applicants have certain paperwork, such as their social security card and household income and tax information, ready when they are filing applications.

Applicants should also ensure they fill in the forms as accurately as possible and use the correct contact information. Weintraub added applicants should make sure the name used on the forms matches the name on the applicant’s social security card.

“The more information on the application, the less likely it is to be kicked out,” Weintraub said.

Reed says applying for Medi-Cal can be frustrating, but there are some ways to speed up the process. If applicants run into roadblocks, they can request a hearing, which usually speeds things up.

For more information about Medi-Cal, go to: www.dhcs.ca.gov/services/medi-cal/Pages/MediBen_Svcs.aspx

For information about county social services offices, go to: www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx

This article was provided by California Black Media, a coalition of Black -owned media outlets.

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Activism

NAACP California-Hawaii State Convention Highlights Black Voter Engagement, and More

A Friday panel featuring NAACP Chairman Leon W. Russell and Regina Wilson, Executive Director of California Black Media, examined Project 2025, an initiative perceived as a potential threat to civil rights, healthcare access, and environmental protection. This session emphasized Project 2025’s projected impact on Black communities, noting that policies within the initiative could diminish gains in civil and environmental rights over decades. Russell and Wilson highlighted the need for vigilant monitoring and community mobilization to address these challenges.

Published

18 hours ago

November 4, 2024

Oakland Post

NAACP State Conference President Rick Callender (right) engages in a discussion on voter engagement and community advocacy with NAACP President and CEO Derrick Johnson during the 37th NAACP California-Hawaii State Convention in Los Angeles. Photo by Rich Woods.

By Bo Tefu, California Black Media

The 37th NAACP California-Hawaii State Convention concluded on Sunday, Oct 27, following four days of discussions and workshops at the Los Angeles Airport Marriott. Bringing together civil rights leaders, policymakers, and advocates from California and Hawaii, the convention operated under the theme “All In.” The participants discussed critical issues impacting Black communities, including criminal justice reform, health equity, economic empowerment, education, environmental justice, and voting rights.

On Saturday, the President’s Fireside Chat brought together NAACP President Derrick Johnson and CA/HI State Conference President Rick Callender, who discussed the urgency of voter engagement and community advocacy.

Guest speakers included Congresswoman Maxine Waters (D-CA-43), who spoke at the Women in NAACP (WIN) Labor Luncheon about the intersection of labor rights and civil rights. California State Superintendent Tony Thurmond delivered remarks at the Leadership Dinner on education equity, focusing on policies to ensure all students have access to high-quality education.

Honors were given to longtime social justice advocate and former Assemblymember Mike Davis for his work in community activism. At the same time, actor and activist Danny Glover and the Rev. Dr. Amos C. Brown received the 2024 Legacy Hall of Fame Awards, recognizing their lifelong commitments to advancing civil rights.

The convention also offered practical workshops, including “What’s On Your Ballot?,” where coalition leaders provided analyses of California propositions, explaining their potential impacts on community rights and resources. The Voter Turnout Workshop provided background and encouraged participants to promote voter turnout through community-centered outreach strategies.

Sunday’s events closed with a Prayer and Memorial Breakfast honoring the contributions of past and current civil rights leaders.

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Activism

Atty Gen Bonta: U.S. Law Mandating Emergency Care to All Patients Faces Threats

The attorney general highlighted that EMTALA is vital for ensuring that no individual is turned away from emergency services based on financial status or insurance coverage. Bonta stated that the law has been a cornerstone of emergency healthcare for decades, providing peace of mind to millions of Americans who might otherwise hesitate to seek urgent medical attention due to cost concerns.

Published

2 days ago

November 3, 2024

Oakland Post

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By Bo Tefu, California Black Media

California Attorney General Rob Bonta emphasized the critical need to protect the Emergency Medical Treatment and Labor Act (EMTALA), mandating that hospitals provide emergency care to all patients regardless of their ability to pay.

In a recent statement, Bonta highlighted the potential threats to this essential legislation amid ongoing discussions about healthcare accessibility in the U.S.

“EMTALA ensures that no one is denied access to emergency medical care, including abortion care, and this federal law is more imperative than ever following the overturn of Roe v. Wade,” said Bonta.

This decision to support the federal government’s case comes at a time when many healthcare providers are facing pressure from rising costs and legislative changes that could undermine existing protections. Bonta called on lawmakers to reinforce EMTALA’s provisions and to combat any efforts aimed at weakening the act, asserting that equitable access to emergency care is a fundamental right.

He urged state and federal governments to ensure that all Americans, particularly marginalized communities, have the necessary access to emergency services without fear of financial repercussions. The brief indicates the coalition’s commitment to healthcare equity, emphasizing that maintaining strong protections under EMTALA is crucial for safeguarding public health.

As discussions around healthcare policy continue, Bonta remains steadfast in promoting initiatives that protect emergency care access, asserting that everyone deserves timely and appropriate medical treatment in emergencies. His efforts align with ongoing legal and advocacy battles to preserve the rights established by EMTALA in the face of evolving healthcare challenges.

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Alameda County

Access Better Health with Medically Tailored Meals – Transforming Health Through Nutrition for Medi-Cal Patients

Launched in 2018, the Medically Tailored Meals pilot program was designed to help Medi-Cal patients with congestive heart failure by reducing hospital readmissions and emergency department visits by providing tailored meals meeting specific dietary needs. The program’s success in improving health outcomes and reducing costly emergency room visits encouraged the Department of Health Care Services (DHCS) to expand the Medically Tailored Meals program to all 58 counties through Medi-Cal transformation and a new set of services called Community Supports.

Published

6 days ago

October 29, 2024

Oakland Post

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The program’s success in improving health outcomes and reducing costly emergency room visits encouraged the Department of Health Care Services (DHCS) to expand the Medically Tailored Meals program to all 58 counties through Medi-Cal transformation and a new set of services called Community Supports.

Medically Tailored Meals are one of 14 new services offered through Medi-Cal that provide members with access to new and improved services to get well-rounded care that goes beyond the doctor’s office or hospital.

Medically Tailored Meals: Overview

Malnutrition and poor nutrition can lead to severe health outcomes, especially among Medi-Cal patients with chronic health conditions. Medically Tailored Meals aim to improve health outcomes, reduce hospital readmissions, and enhance patient satisfaction by providing essential nutrition.

Key Features:

Post-Discharge Delivery: Meals are delivered to patients’ homes immediately following discharge from a hospital or nursing home.
Customized Nutrition: Meals are tailored to meet the dietary needs of those with chronic diseases, designed by registered dietitians (RD) or certified nutrition professionals based on evidence-based guidelines.
Comprehensive Services: Includes medically tailored groceries, healthy food vouchers, and food pharmacies.
Educational Support: Behavioral, cooking, and nutrition education is included when paired with direct food assistance.

Key Benefits:

Address Food Insecurity: Mitigates poor health outcomes linked to food insecurity.

Support Complex Care Needs: Tailored to individuals with chronic conditions.

Improve Health Outcomes: Studies show improvements in diabetes control, fall prevention, and medication adherence.

Patient Testimonial:

“My diabetes has gotten better with the meals. I’ve kept my weight down, and I feel much better now than I have in a long time. I’m one of the people this program is meant for.” — Brett

Eligibility:

Eligible Populations: Eligible Medi-Cal members include those with chronic conditions like diabetes, cardiovascular disorders, congestive heart failure, stroke, chronic lung disorders, HIV, cancer, gestational diabetes, and chronic mental or behavioral health disorders. Also, those being discharged from a hospital or skilled nursing facility or at high risk of hospitalization or nursing facility placement are also eligible.

Service Limitations: Up to two meals per day for up to 12 weeks, extendable if medically necessary. Meals eligible for reimbursement by alternate programs are not covered.

Cost Savings and Improved Health Outcomes:

Health Outcomes: Research indicates a 22% to 58% decrease in emergency department visits and a 27% to 63% decrease in inpatient admissions among Medically Tailored Meals recipients, translating to significant health care cost savings.

Project Open Hand: A Success Story

Project Open Hand has been a leader in providing Medically Tailored Meals, significantly impacting the lives of Bay Area Medi-Cal patients with chronic illnesses. Since its inception, Project Open Hand has delivered nutritious meals to individuals with diabetes, HIV, and other serious health conditions, demonstrating remarkable health improvements and cost savings.

Key Achievements:

Improved Health Outcomes: Project Open Hand’s research found a 50% increase in medication adherence among recipients of Medically Tailored Meals.

Reduced Hospitalizations: Their program showed a 63% reduction in hospitalizations for patients with diabetes and HIV.

Enhanced Quality of Life: Patients reported better health and increased energy levels.

Project Open Hand ensures that each meal is prepared using fresh, wholesome ingredients tailored to meet the specific dietary needs of its clients. By partnering with Medi-Cal managed care plans, Project Open Hand continues to provide life-saving nutrition to those who need it most.

Join Us in Our Mission

You can experience the profound impact of Medically Tailored Meals by joining the Medi-Cal Community Supports services initiative. Your involvement can make a difference in promoting your health through nutrition.

Learn More

For more information about Medically Tailored Meals and how to get involved, call the state’s Medi-Cal Health Care options at 800-430-4263 or contact your local managed care plan.

In Alameda County, Medi-Cal recipients can contact:

* Alameda Alliance for Health: 510-747-4567

* Kaiser Permanente: 855-839-7613

In Contra Costa County, Medi-Cal recipients can contact:
* Contra Costa Health Plan: 877-661-6230

* Kaiser Permanente: 855-839-7613

In Marin County, Medi-Cal recipients can contact:
* Partnership Health Plan of California: 800-863-4155

* Kaiser Permanente: 855-839-7613

In Solano County, Medi-Cal recipients can contact:
* Partnership Health Plan of California: 800-863-4155

* Kaiser Permanente: 855-839-7613
Your health and well-being are your health care provider’s top priority. Medically Tailored Meals are designed to enhance quality of life by advancing health care through the power of nutrition. Experience the benefits today, and take the first step toward a healthier you.