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California Senior and Disabled who are both Medicare and Medi-Cal

  • Totally Liberal Dem (1479 posts)
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    California Senior and Disabled who are both Medicare and Medi-Cal

    Do NOT take the choices of coverage that appear to be mandated upon you by the Counties and State…such as Molina, Kaiser, etc.  You are entitled to be covered by ALL insurance companies doing business in California.  Thus, you can have ANYTHING you want as your provider for your healthcare.  No one tells you this…they allow you to think that you have to pick from the WORST of the WORST providers licensed to provide health insurance coverage.  Those on Medicare and Medi-Cal (California Medicaid) are not limited to changing providers during any certain yearly time period.  You can change any time.  What IMO you should do is call an insurance agent who carries different lines.    I have  an agent who I have use to help those who need help getting through this landmine and getting the best coverage for particular needs.   He does not get one single cent from anyone he places with as provider and he is excellent.  He will go over your health problems and needs and will find what coverage gets you the most and best for your particular needs.  Look around and see what agents are available in your area and talk to them and get help.  Do not let the State and Counties in California limit your coverage to MediConnect providers if you are a California Dual (Medi-Medi coverage).

    KauaiK, Downwinder, jwirr and 1 otherNV Wino like this
    THE ARTIST FORMERLY KNOWN AS HEPBURN!!!! 

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6 replies
  • tiamat (678 posts)
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    1. Medicare is my insurance carrier.

    I’m in California and I could go to any doctor that accepts Medicare without any insurance company.

    • Totally Liberal Dem (1479 posts)
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      2. That is true.

      My post was intended for those who are what is known as California Duals — have both Medicare and Medi-Cal coverage.  A few years ago, the state discontinued allowing the Duals to choose and pick their own medical providers who accepted both Medicare AND Medi-Cal as coverage and shunted them into mandated programs for their care.  If you have only Medicare, this does not effect you.  It only effects the elderly and disabled, low income, who are covered by both Medicare and Medi-Cal.

      THE ARTIST FORMERLY KNOWN AS HEPBURN!!!! 
  • Live and Learn (1506 posts)
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    3. Nobody mandates anything. You are supplied with information an all the plans

    available and are free to choose the one you want.

    By the way, the HMO’s you refer to are not the worst of the worst.  Kaiser, for instance, is non-profit and is used by a majority of government workers.

    • Totally Liberal Dem (1479 posts)
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      4. Not true.

      See links to Medi-Connect.

      Yes, the ones that the State and County tell you to select from are by far the worst of the worst.  That is the point of the post.  Many Cal Duals do not know that they can choose from anything.  They only info supplied for LA County by the State and County for those on Medicare and Medi-Cal are:

      “The California Department of Health Care Services (DHCS), in conjunction with the federal Centers for Medicare & Medicaid Services (CMS) are directly contracting with L.A. Care Health Plan, Health Net, CareMore, Care1st Health Plan and Molina Healthcare for the Cal MediConnect program in Los Angeles County to make the process of insuring every citizen seamless and easy to understand.”

      http://www.lacare.org/health-plans/cal-mediconnect/plan-overview

      Again:  The point of my posting is that a Cal Dual does NOT have to choose from only the list supplied…which as I said are the worst of the worst.  ALL providers in California are MANDATED to provided coverage to Cal Duals.   Now if YOU have something that says that, for example, L.A. County is giving information for ALL plans for those who are Cal Duals, please give me a link.  The Mediconnect L.A. County website (above link) does not do this.

      Kaiser to me is one of the worst of the worst because in order to have Kaiser coverage, one MUST give up all his/her rights to sue for Medical Malpractice.  One is limited to arbitration only and…this is what makes it one of the worst providers…all three members of the mandated arb panel are chosen by Kaiser.  That is why those organizations interested in paying the least for coverage for employees often use Kaiser.  Just because it is non-profit does NOT mean that it is a good plan.  They avoid the responsibility for medical errors at the expense of their patients and because of that, it is one of the worst plans available IMO.

       

      THE ARTIST FORMERLY KNOWN AS HEPBURN!!!! 
      • Live and Learn (1506 posts)
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        5. Well I find it rather humorous that many here complain about

        the great health benefits government workers receive, yet you are calling the plan most of them are on, one of the worst and not fit for those on aid.

        In fact, in Los Angeles County, it is rather difficult to get Kaiser if one is on Medi-Cal (California’s Medicaid program) because Kaiser severely limits in enrollment.

         

      • Live and Learn (1506 posts)
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        6. And Kaiser isn't even on the list from LA Care.

        From your link:

        The California Department of Health Care Services (DHCS), in conjunction with the federal Centers for Medicare & Medicaid Services (CMS) are directly contracting with L.A. Care Health Plan, Health Net, CareMore, Care1st Health Plan and Molina Healthcare for the Cal MediConnect program in Los Angeles County to make the process of insuring every citizen seamless and easy to understand. Cal MediConnect began voluntary enrollment in April 2014 in Los Angeles County.

        By the way, LA Care also provides Medi-Cal services and the list is pretty much the same. I think most people are pretty happy with the services offered.