DHCS MEDIL 14-17: Instructions to Counties When Beneficiaries Age Out of Certain Medi-Cal Programs or Reach the End of a Time Limited Coverage Period and Burman Holds

This letter furthers guidance already provided by DHCS that requires counties to continue not to make any negative changes to Medi-Cal cases for a period of time until certain programming can be completed by CalHEERS and SAWS that allow an accurate redetermination of Medi-Cal eligibility. This letter, linked here, tells counties how to continue cases that are age-limited or time-limited.

DHCS ACWDL14-16: Income Verification for CalHEERS Pended Applications and the Processing of Retroactive Medi-Cal Eligibility

This letter instructs counties that when CalHEERS pends a MAGI Medi-Cal application because it is not reasonably compatible with data hub information, counties must conduct ex parte review to determine if income is already verified elsewhere. Also, the letter indicates that MAGI Medi-Cal applicants can only get retroactive coverage to January 1, 2014 but that individuals who applied with single streamlined applications can get coverage back to 2013 if otherwise eligible. Click here to read the letter.

DHCS ACWDL 14-06: Express Lane Enrollment for CalFresh Eligible Adults and Children

CMS authorized DHCS to grant MAGI Medi-Cal eligibility automatic to CalFRESH eligibles who do not have current Medi-Cal eligibility. Individuals must be under 65, not blind or disabled and without Medicare or Medi-Cal.  These individuals will receive an opt-in letter and may opt in by phone, mail or online.  The letter (here) details how express lane enrollees can remain eligble and the impact of changed circumstances as well as CalFRESH termination.

DHCS ACWDL 14-05: Continuous Eligibility for Children

This letter, gives counties instruction on the application of Continuous Eligibility for Children (CEC) in light of new federal guidance and the transition of Healthy Families Program (HFP) to Medi-Cal. Provides that children on both MAGI and non-MAGI Medi-Cal children retain eligibility for 12 months (starting with date of eligibility) or until they turn 20.  It further explains noticing and procedures for changed circumstances and also clarifies that former foster youth and former HFP enrollees are not subject to 10 day reporting requirement that Medi-Cal beneficiaries with other linkages are subject to.  Read the entire letter here.