NSCLC: CCI Tips

From our colleagues at NSCLC:

Beneficiaries Who Opt Out of Cal MediConnect are Enrolled in Medi-Cal Plans Effective the Following Month.  Dual eligible beneficiaries who opt-out of Cal MediConnect must still enroll in a Medi-Cal plan.  The Medi-Cal plan will become effective the month after the beneficiary opts out and not necessarily the same month as the beneficiary’s Cal MediConnect passive enrollment date.  For example, if a beneficiary is slated for passive enrollment into Cal MediConnect in October 2014 and she opts-out of Cal MediConnect in August, she will be enrolled in the Medi-Cal plan as of September 1.   


Reports of Opt-Out Problems for Some Beneficiaries.
  Some beneficiaries slated for passive enrollment into Cal MediConnect continue to report that they have not had their opt-out requests processed and were enrolled into Cal MediConnect plans.  DHCS indicates that it is investigating these problems and developing fixes.  If you serve beneficiaries who are impacted by this issue, please contact NSCLC and the CCI Ombudsman at (855) 501-3077.   


Under the CCI, Dual Eligible Beneficiaries Can Be Enrolled in Two Different Managed Care Plans.
  In addition to Cal MediConnect plans, dual eligibles have the choice to enroll in a Medicare Advantage plan or Duals Special Needs Plan (D-SNP).  Individuals who are enrolled in these plans for their Medicare benefits still need to choose a plan for their Medi-Cal benefits.  In some instances, beneficiaries will be enrolled in non-matching plans.  Read More » 

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
  • St. Barnabas Senior Services

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