The Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) announced new funding to help improve coordination of care for Medicare-Medicaid enrollees. The funds will develop ombudsman programs for coordinated health plans for dually eligible individuals.
Blue notification letters continue to be sent out by Healthcare Options to the address that is on file with them, which is often times incorrect. A large proportion of these people have dementia, are unstable or suffer from chronic mental illness and tend to move frequently without being able to notify Medicare of their new location. Thus, these individuals never receive the blue envelope and are being passively enrolled against their will. This practice is unconscionable.
It is important to be sure Cal MediConnect notifications in blue envelopes reach the right addresses. If you have Medicare and Medi-Cal, or know or represent someone who does, call your county’s office to confirm that your / your representee’s most recent address is on file.
Click here to learn how to provide your most current address to the county and state.
This is not possible. There are 1000s of letters that have gone out already and will continue to go out.
A woman I see at a nursing home needs a surgery. She opted out of Cal MediConnect (on the Medicare side), but she WAS STILL ENROLLED INTO an HMO on 10.1.14. Staff at the facility have called Healthcare Options numerous times and a rep has promised that the resident will be put back into traditional Medicare ASAP, but nothing has changed. This woman needs a surgery and the HMO will take forever to authorize it or refuse to do so. What a tragedy!
Thank you for contacting us. We would be happy to look into the situation and help ensure this woman has access to the services she needs. You can send us more information at info@calduals.org. Or you can contact the Ombudsman program at 1-855-501-3077.