Of the nearly 3 million Californian’s enrolled in Medi-Cal, Covered California estimates that approximately 2 million became newly eligible under the ACA expanded Medi-Cal rules. Many of the new Medi-Cal members are working families and individuals. They have little time to sit on hold with their local county social services department to correct Medi-Cal errors or update their income. Individuals and families can designate or authorize a representative on their behalf to work with Medi-Cal to update information or correct errors.
Covered California Authorized Medi-Cal Representative
In late June, Covered California alerted Certified Insurance Agents and Certified Enrollment Counselors to the Medi-Cal Authorized Representative form. (Not to be confused with the Authorized Representatives that can be appointed for the Covered California consumers). Download the full news brief at the end of the post.
For the purpose of making the enrollment and retention process as simple as possible, Covered California would like to highlight a particular form from the California Department of Health Care Services: the “Appointment of Representative” form, also known as “Form MC 306.” This form gives certified enrollers the right to act on behalf of the consumer in regards to their application for, or redetermination of, Medi-Cal benefits, by submitting any requested verification documents, accompanying the consumer to required face-to-face interviews, obtaining information regarding the consumer’s application status, providing medical information to county departments, assisting in hearing processes and receiving a copy of a specific notice of action, at the request of the applicant.
Medi-Cal MC 306 Form
The MC 306 (don’t you just love bureaucratic file names) is pretty straight forward in what it allows the authorized representative to do on behalf of the Medi-Cal member. Download the form at the end of the post.
THIS AUTHORIZATION ENABLES THE ABOVE NAMED INDIVIDUAL TO:
- submit requested verifications to the county welfare department;
- accompany me to any required face-to-face interview(s);
- obtain information from the county welfare department and from the State Department of Social Services, Disability Evaluation Division, regarding the status of my application;
- provide medical records and other information regarding my medical problems and limitations to the county welfare department or the State Department of Social Services, Disability Evaluation Division;
- accompany and assist me in the fair hearing process; and
- receive one copy of a specific notice of action from the county welfare department, at the request of the applicant/beneficiary.
Who will sign up to be an authorized Medi-Cal representative?
To be really honest, I don’t think too many Certified Enrollment Counselors are going to volunteer to be Authorized Representatives for their clients. One phone call alone can soak up an hour’s worth of time for which there is no compensation except that warm fuzzy feeling reward of helping someone else. Agents may be similarly dis-inclined to offer their services as an Authorized Representative for their clients. However, If an agent has a mixed household, some family members on private health insurance and children in Medi-Cal, then their might be a financial incentive to become the Authorized Rep and make some phone calls.
There have been plenty of times when I wished I could have called on behalf of a client. Medi-Cal can give people the run around and not explain things in simple English. The level of frustration I hear in people’s voices from dealing with Medi-Cal is heart breaking. They don’t realize that they are actually exacerbating people’s health conditions with all the added uncertainty and anxiety they cause. As an agent, I might just accept being an authorized representative for Medi-Cal if I could make a client’s life a little better by sparring with a county social worker so they don’t have to.
Consumers just want to change their income
This biggest element that either agents or Certified Enrollment Counselors can tackle with Medi-Cal for clients is changing the member’s income. We have found that once a consumer is dropped into the well of Medi-Cal, Covered California has no rope to pull them out. Medi-Cal puts a soft pause or lock on the account and all updates must go through county welfare department. Consequently, if a family member gets a pay raise or a new job that would lift them out of Medi-Cal eligibility, they can’t talk to Covered California who they enrolled with, they have to engage a county social services case worker to update the income.
Untying the Medi-Cal knot
Medi-Cal is a whole new world for most of the newly eligible members. Many people have found that trying to talk to the county Medi-Cal office is like dealing with a 1970’s era DMV location: slow and frustrating. Perhaps if people can appoint an Authorized Representative they can focus on their job and family and let the agent or CEC untangle the Medi-Cal knot. I know there are families that would gladly pay someone else to engage with Medi-Cal then to have to spend hours learning the system just to report a simple change of income or address.
Covered California Medi-Cal Authorized Representative news brief
Medi-Cal MC 306 Form