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.

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.

 

 

Establishes new limits for all of the Medi-Cal programs for which eligibility is based on a percentage of the Federal PovertyLevel (FPL) effective April 1, 2014.  Note the addition of many new FPL limits associated with MAGI coverage under the ACA.  The letter, here, includes a 2014 FPL chart as well.

This letter (here) explains new ex parte review process for MAGI Medi-Cal annual reviews.  Informs counties that pre-ACA Medi-Cal cases will be redetermined starting in May 2014 and provides a schedule for January 2014 -April 2014 redeterminations. At the first post-2014 counties will collect baseline information from pre-ACA Medi-Cal enrollees in order to move them into MAGI Medi-Cal by sending the Request for Tax Household Information (copy is attached to the letter). The errata to this letter, available here, states that redeterminations will not begin until June 2014.

Instructs counties to manually correct cases for applicants with immediate medical need incorrectly found ineligible by CalHEERS, for immigrants who should get full scope Medi-Cal but erroneously received restricted scope through CalHEERS, and for Former Foster Care youth up to 26 due to SAWS programming issues.  The letter, available here, further directs counties to report any new eligibility problems to DHCS and states that DHCS will fix the issues within 2 days.

This letter provides temporary guidance to counties on certain workarounds necessary to process MAGI Medi-Cal eligibility while the SAWS and CalHEERS interface is being improved.  This letter addresses how to manually process MAGI Medi-Cal applications with two primary tax filers on the same application as well as how to process cases that are rejected by CalHEERS because the applicant does not meet the 5 year immigration bar but is eligible for Medi-Cal per California rules.  To see the entire letter, click here.