The enrollment of individuals and families under the expanded Medicaid provisions of the ACA is not a slam dunk with either the mailing in of an application or clicking “enroll” on a website. A variety of documents will usually need to be sent to complete the enrollment at the county level. Not submitting the verification documents could ultimately delay enrollment for people who desperately need the insurance.
Medi-Cal Verification process is a mystery
The game plan at Covered California is that families applying for health insurance will either be routed to private health insurance with premium assistance or, if their forecasted income is below the expanded federal poverty line, the application is transferred to the respective county that the applicant resides in for enrollment into Medi-Cal. With absolutely no training on how California’s Medicaid system, known as Medi-Cal, actually works, most agents and possibly Certified Enrollment Counselors are clueless as to the enrollment process. Update: newly released chart on how each state will attempt to verify Medicaid eligibility from State Reforum: State Medicaid and CHIP Eligibility Verification Plans
Where do you live?
It is my understanding that there is no more asset test (How many cars do you own? How big is your bank account?) for qualification for Medi-Cal. However, there still is a residency requirement along with immigration and income verification. The county health and human services office will have to document and verify that the applicant’s lives in the county are lawful/eligible immigrants and their current income level. Residency Verification: whether applying online or with a paper application, Covered California will always need to verify residency for Medi-Cal because it goes by county. Always submit some sort of proof of residency such as a car registration or utility bill.
Confusing Covered California paper application
The Covered California paper application states on page 18 that if the applicant wants to be considered for Medi-Cal, they (Covered California or the county is not specified) will contact the applicant to get property and asset information. Well, I thought that property and assets were no longer part of the eligibility test? This is just a sample of the confusion that surrounds the Medi-Cal system where getting real information is like solving the mystery of Stonehenge. And when we are working with homeless folks, the staid and formal rules just don’t work.
Getting through the bureaucratic tunnel
The online application through the Covered California website automatically puts the applicant into a Medi-Cal path when the income is below the threshold. At the end of the online application the applicants are instructed to upload residency and income verification. The applicant is not instructed that someone will contact them and there is no mention of assets or property. It’s all a little confusing. We need to help Medi-Cal eligible families traverse the dark tunnel of bureaucracy so they can safely exit with health insurance at the other end.
Are counties ready for the flood of Medi-Cal applications?
Frankly, I can see most counties being overwhelmed with Medi-Cal applications and being swamped with trying to contact people for verification documents. This is where agents and certified enrollment Counselors need to be proactive and collect, copy, scan, upload and/or mail the documents to Covered California for the client. If at all possible, the applicant needs to send all requested documents.
Don’t expect a call anytime soon
As of November 15th, six weeks after the start of open enrollment, neither Covered California nor any county official has contact any of my clients requesting verification documents. I’m instructing my clients to make copies of the necessary documents and mail them to Covered California with a cover letter which includes their case and application number. Those two identifiers can be found in the upper left hand corner of the screen after logging into the Covered California website.
Covered California, P.O. Box 989725, West Sacramento, CA 95798-9725
January 1, 2014 or 2015?
With luck, those verification documents will find their way to the right application and county. For some Californians, if we send the documents with a paper application, upload scanned docs, or mail them to Covered California, they might get Medi-Cal by December for a January health insurance start date.
- 86Medi-Cal was one of the biggest mysteries during open enrollment in the new ACA health plans. Even though Covered California advertised a “no wrong door” approach to signing up for health insurance, when a client had to go through the Medi-Cal door, not even Covered California could tell them what to expect. Finally, seven months…
- 83Covered California hosted another webinar to provide a progress update of the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) website. In short, this is the website Californians will use to enroll in one of the qualified health plans offered in their area through Covered California. There will also be paper applications and call center…
- 71The designers of the Covered California CalHEERS online enrollment system were hoping to reduce or eliminate paper by allowing requested documents to be uploaded for verification. Many Californians are finding that uploading documents isn't as easy as sticking the bank card in the ATM. Necessary documents to verify eligibility Covered California may request a variety…
- 71Covered California continues to sabotage their customer service operations by sending out confusing eligibility and verification request letters to new applicants of ACA plans. Individuals and families receiving these letters are confused by Covered California informing them what programs and plans they aren't eligible for, no mention of what they have enrolled in and requests…
- 68While most people are thrilled with the ability to get affordable health insurance through Covered California, others are trying to avoid the premium free health insurance being offered. Specifically, some families and individuals are trying to figure out how to avoid having either their children or their family automatically enrolled in Medi-Cal. Inflating the income of the…