Tens of thousands of Californians are losing their health insurance every month as the state resumes checking people’s eligibility for Medi-Cal, which it suspended during the COVID-19 public health emergency.
About 16 million people in California will be screened for eligibility from June 2023 to May 2024. About half of those screened were automatically renewed as officials were able to verify their information in the system. Others were given yellow renewal packets to fill out and return to their county hospital.
More than 300,000 Californians have lost their eligibility for Medi-Cal since July 1. According to state data, most of them lost coverage in June and July for procedural reasons, such as not submitting their renewal forms or providing false information on their forms.
Some people who lose coverage are no longer eligible because of changes in their personal lives, such as getting a better-paying job. However, some may lose their coverage due to paperwork errors or simply not receiving notification in the mail.
“That’s because people haven’t had to renew their health insurance coverage for so long,” said Cary Sanders, senior policy director at the California Panethnic Health Network. “There could be 2 to 3 million Californians who could lose their health insurance because of this change alone because there would be people who wouldn’t know what to do.”
Here are some answers to questions about what you can do if you lose coverage and how to appeal.
CANCELLATION
You will be notified by email. If you didn’t receive a notification but still think you may have lost coverage, you can call your local Medi-Cal office to check eligibility or go to your regular clinic or hospital where this information will be available can be obtained for you.
If you have questions about Medi-Cal eligibility, you can contact the state department of health, which administers the Medi-Cal program. You can contact your Medi-Cal Eligibility Division at (916) 552-9200.
MAKE
Your next step will depend on how much time has passed since you lost your coverage, as indicated in the official notification letter.
The state has instituted a 90-day appeal period if you have lost coverage, even if you qualify.
If you are within the 90 day period, you must immediately complete the yellow renewal packet or provide the missing information and mail it to your County Medical office. If you lost your package or mailed it but were still deregistered, call your local Medi-Cal office or go to your regular clinic or hospital to determine next steps.
If you are unable to submit your information to your local Medi-Cal office due to accessibility issues and are running out of time, ask the office staff to accept your documents electronically or by telephone.
If you have exceeded the 90-day deadline, you will be asked to reapply for Medi-Cal benefits. This means starting a completely new application.
APPEAL
Tatiana Fassieux, training and education specialist at California Health Advocates, a nonprofit that advocates for Medicare, said people should remember they have a right to appeal.
If you have received a notice of disenrollment, you can request a fair hearing and appeal the loss of insurance coverage. This ensures that your benefits will continue until the hearing is complete.
“A lot of people take the letter literally, don’t read it and don’t appeal,” he said.
According to the state Department of Health, adults under 26 or over 50 can qualify for Medi-Cal regardless of their immigration status. Medi-Cal does not share information with immigration authorities, so undocumented Californians should not be afraid to seek help. Starting January 1, Californians of all ages can qualify for Medi-Cal regardless of their immigration status.
OTHER INSURANCE
If you no longer qualify for Medi-Cal, you may still be able to get low-cost health insurance through Covered California, the state’s marketplace for health insurance plans.
Anyone earning up to 250 percent of the federal poverty level — or $33,975 for an individual or $69,375 for a family of four — would be eligible for low-premium plans through Covered California. You may also be eligible for additional health insurance subsidies through the Affordable Care Act (ACA), including upfront premium tax credit and cost-sharing reduction plans.
If you are over 65 or have a disability, you may also be eligible for Medicare, which can help pay for hospital costs, medical care and even prescription drugs.
How to protect yourself
Keep an eye out for emails sent to you by your regional Medi-Cal office. If you recently moved, be sure to update your address on the Medi-Cal website or call your local office.
You are expected to renew and update your Medi-Cal insurance coverage each year. Therefore, keep all important information in an accessible place.
“You should have your documents, such as tax returns and medical records, on hand,” Fassieux said.
You can sign up for renewal reminders through the state’s renewal website: keepmedicalcoverage.org. This resource is also available in Spanish in the state.
MORE RESOURCES
The state Department of Health has several resources to help you, including contact information for your local Medi-Cal office, schedules for community events and health fairs where you can learn in person, and guides on what to do if you need Medi-Cal lose. Lime. Call coverage.
If you need help re-enrolling in Medi-Cal, you can also call the Medi-Cal Ombudsman’s Office. The office is a neutral point of contact that can help you resolve any issues you may have with the program. You can contact the Ombudsman’s Office at (888) 452-8609.
There are also several third-party services that can help you get Medi-Cal again.
Health Consumer Alliance is a free assistance program funded by The California Endowment, Covered California, the state Department of Managed Health Care and the Blue Shield Foundation. Provides legal services and can help you renew your Medi-Cal insurance coverage. To contact us, you can read the Medi-Cal Renewal Guide or call toll-free 888-804-3536.
You can contact BenefitsCal, which also offers Medi-Cal assistance. The website has translations in 20 languages.
OLD PEOPLE
According to the health policy organization Justice in Aging, medical school withdrawals are more common among seniors and people with disabilities. According to the Ministry of Health and Human Services, seniors, pregnant women and certain children under the age of 21 experienced an unsubscribe rate of 26.7 percent in June 2023, compared to the overall average rate of 21 percent.
Tiffany Huyenh-Cho, a health advocate at Justice in Aging, said seniors and people with disabilities have dual eligibility, meaning they are eligible for both Medicare and Medi-Cal.
“Dual eligibles are a very diverse group with very high chronic needs and are more likely to be people of color,” he said. “Their health disparities and chronic conditions will be exacerbated by the loss of Medicaid.”
Seniors and other dual-eligible individuals often use their Medi-Cal benefits to cover their Medicare premiums as well as any comprehensive benefits not included in Medicare. Losing Medi-Cal means they may lose those additional benefits and face having Medicare premiums deducted from their Social Security checks, Huyenh-Cho said.
“This poses a risk that people will not be able to pay their rent and other essentials such as clothing, food and utilities,” he said. “One of the big concerns we have is that this puts people at risk of economic insecurity and potentially homelessness due to this loss of income.”
Those who need additional support can contact federally supported enrollment counselors, which are community organizations and social services that help vulnerable populations through this process.
The Department of Health Care Services also released a toolkit on social media to raise awareness about redeterminations so people can renew their coverage before they are disenrolled. This kit is available in 19 languages.
