As of 9/26/16, CalHEERS implemented a change to introduce the Carry Forward Status to reduce gaps in coverage while consumers transition between Covered California and Medi-Cal pending county eligibility determinations. The flag in CalHEERS triggers a new notice to inform individuals of CFS.
Previously, DHCS and counties used Express Lane aid codes in a batch process pending county final eligibility determinations during the Covered California annual redetermination or change in circumstances reporting. This, however, could result in a gap in coverage when, during the final eligibility determination, a person was found not to be eligible for Medi-Cal and was referred back to Covered California without retroactive coverage. This process has been discontinued.
Now, CalHEERS will automatically place individuals into CFS when redetermination of eligibility results in potential MAGI Medi-Cal eligibility. The individual will continue with Covered California coverage until the county completes a full Medi-Cal determination. CFS will apply when a consumer reports a change that results in MAGI eligibility, when a consumer is determined MAGI eligible during the renewal period, when a consumer reports a change after the renewal is complete, and when a consumer reports a change after Covered CA eligibility has gone into effect.
During the CFS process, counties must treat cases as a new application for benefits. Counties are required to send notices to affected beneficiaries. Applicants transitioning from Covered CA to Medi-Cal may be eligible for the three-month retroactive Medi-Cal coverage period.
DHCS ACWDL 17-07 (February 24, 2017).