California Health Report: Adding Insult to Injury: The Tale of the Blue Envelope

By Matt Perry

Imagine you are an older adult in your 60s or 70s, perhaps even your 80s. You’ve lived a long life of exquisite joy and sorrow. Today, you suffer from diabetes, heart disease, dementia, and a mental health problem like depression or anxiety.

Then, one day in the mail comes a blue envelope.

Inside is a notice written in jargon you can’t fathom, declaring that you’ve been enrolled in a new government program that will completely change your healthcare.

That’s how more than a million Californians are being introduced to the Cal MediConnect program for the state’s “dual eligible” population, so called because they are typically old, sick, disabled and poor – and thus receive benefits from both Medi-Cal and Medicare.

On Jan. 1 the largest number of Californians – about 125,000 – have been slated for enrollment in Cal MediConnect, which is being rolled out in stages within seven pilot counties. It’s the largest rollout month since the program began in April.

Patients are automatically enrolled in the controversial program, yet are given a choice to “opt out.” The state hopes to save $1 billion annually after it’s implemented statewide, and hopes that patients will get improved care as Medi-Cal and Medicare patients are managed under a single roof.

So far, the program has slogged through previous rollouts with a litany of complaints. Some patients never received blue envelopes. Some couldn’t understand the program. Some were told they couldn’t opt out. Orange County’s date slipped when CalOptima, the county program for Medi-Cal patients, suffered sanctions following an audit. Computer glitches ballooned.

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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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