Medi-Cal is Expanding to More Californians

Starting May 1, full scope Medi-Cal benefits will be available to more Californians than ever before.

The Older Adult Expansion, which Gov. Gavin Newsom signed into law last summer, expands the scope of Medi-Cal coverage to nearly a quarter million low-income Californians aged 50 and older.

“We’re investing California’s historic surplus to accomplish transformative changes we’ve long dreamed of,” Newsom said at the bill signing.

Full-scope Medi-Cal benefits will include:

  • Medical
  • Dental
  • Vision
  • Mental health
  • Medications

You do not need to be a U.S. citizen to qualify. All other Medi-Cal eligibility rules, including income limits, will still apply. People currently enrolled in restricted scope —or “emergency” — Medi-Cal will automatically become enrolled in full-scope Medi-Cal coverage starting May 1, 2022. You will be required to select a health plan and a provider. You can reach out to us to continue your care with your AltaMed PCP.

If you do not have restricted Medi-Cal, we urge to apply today. As of August 1, 2022, you will be dis-enrolled from MHLA.

In either case, AltaMed can help you transition to full-scope Medi-Cal. We can assist you with the choice form to continue with your AltaMed PCP or enroll in restricted (emergency) Medi-Cal so that you can transition to full-scope Medi-Cal on May 1.

To schedule your appointment with one of our Patient Care Coordinator, call AltaMed at 877-462-2582, option 2, before May 1.

We Can Help You Apply

AltaMed is able to answer any questions you have about Medi-Cal and can even help you apply. To schedule your appointment with one of our Patient Care Coordinator, call AltaMed at 877-462-2582, option 2.

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Open Registration

You Have Questions about Open Enrollment and We Have Answers

The end of the year marks the opportunity for Californians to get insured during the open enrollment period. We want to make sure you have the best information available so you can decide about the coverage that is right for you and your family.

In addition to this FAQ, we offer resources for more information and can also walk you through your options for free.

Get help in English at (833) 444-5560, or in Spanish at (833) 444-5570.

Q: What is open enrollment?

A: Open enrollment is the time when everyone has a chance to choose their health care and insurance coverage for the next calendar year. People can switch to another plan if they feel it does a better job of meeting the health care needs for them and their families. They can also stick with the plan they have.

There are some important things to know like:

  • The cost, or premiums
  • Which doctors and hospitals you can visit
  • How much office visits, prescriptions, or other services cost
  • How much you will have to pay out of pocket
  • If additional services like dental, vision, or counseling is covered

Open enrollment is also the time when those on Medicare can choose the doctors or health systems they want to use. We can help you switch if you want to see AltaMed doctors in 2022.

Q: When is open enrollment?

A: The deadline for Medicare is Dec. 7. Open enrollment for Covered California is Nov. 1 through Jan. 31.

Mom and Son Visiting the Doctor

Q: Who is eligible for Medicare?

A: Medicare is usually reserved for people 65 years old and older. In addition to the open enrollment period, you can sign up three months before you turn 65. Younger people who require dialysis for kidney failure or need a transplant, are also eligible.

Medicare has two parts: Part A and Part B. Part A is hospital insurance and Part B is medical insurance. Part A is free if you’re at least 65 and you or your spouse paid Medicare taxes for at least 10 years. There is a monthly premium for Part B which comes out of your monthly Social Security check. The premium is based on income. In 2021 it ranged from $148.50 to $504.90.

Q: Should I just take the insurance offered by my employer?

A: That may be the simplest thing to do, but it might not be what’s best for you and your family. It could be expensive, even if your employer pays for part of it, and it might not provide you the right coverage. That’s why it’s important to research your options.

You could be eligible for coverage through Medi-Cal or qualify for discounts through the Covered California marketplace.

Doctor and Senior Patient

Q: What happens if I don’t choose?

A: It’s likely your plan will continue if you’re covered through Medicare. You may also get automatically assigned to a plan offering comparable coverage at a price similar to your coverage through your employer or Covered California. Otherwise, you might have to re-enroll each year.

Q: What happens if I don’t have coverage and miss the deadline?

A: If you miss the deadline for your employer’s insurance, you have to wait until next year unless you have a qualifying life event. You could get a short-term plan, be eligible for Medi-Cal, or the Children’s Health Insurance Program (CHIP), or be eligible for Covered California. If you miss your deadline to sign up for Medicare, you can enroll during the general enrollment period that runs from Jan. 1 to March 31 every year. Your coverage, however, won’t start until July 1.

Q: What is a qualifying life event?

A: These are events that allow you to change, cancel, or enroll in new coverage outside of the open enrollment period, they include:

  • Getting married
  • Having a baby
  • Losing a job or experiencing a change to your income
  • A death in the family
  • Moving to a different ZIP code
  • Becoming a U.S. citizen

Q: How can I save money on coverage?

A: You can apply for tax credits or cost-sharing reductions if you purchase a plan through Covered California. That can reduce what you pay.

Some health insurance plans offer discounts if you maintain a healthy weight, enroll in an exercise program, or take part in activities your company requests. Other ways to save money include:

Q: Where can I get help choosing the right insurance?

A: AltaMed has professionals dedicated to help you understand your health care options. They can provide you with:

  • Free one-on-one enrollment assistance over the phone
  • Bilingual certified enrollment counselors
  • Information about a variety of health care options including:
    • Covered California
    • Medi-Cal
    • Medicare

Make your appointment today by calling (877) 462-2582.

Learn other ways to get the most from your coverage, regardless of the plan you’re on. And remember, we’re here for you. Call with your questions about selecting coverage that can help your whole family grow healthy – in 2022 and for years to come.

Couple in video call with doctor

Extending Telehealth Services Past the Pandemic a Priority for AltaMed

AltaMed began offering telephone and video visits during the pandemic as a way to keep our members safe while continuing to meet their health needs. Insurance will continue to cover those visits throughout the pandemic.

AltaMed is advocating for that coverage to extend beyond the pandemic to serve the needs of those who would rather receive service from the comfort and safety of their homes.

Please review these guidelines to make sure you are getting the most from your telephone or video visits.

What Is Telehealth?

Woman on Video Call with Her Doctor

Using either a cell phone, landline, a tablet, or a laptop, you can talk to an AltaMed doctor over the phone or through video. You can discuss the same kind of things you would at a regular doctor visit, including your symptoms and concerns. You may also be able to get an immediate diagnosis, learn about your treatment options, and even get a prescription if your doctor thinks it’s appropriate.

If you are experiencing a significant loss of blood, breathing problems, fainting or loss of consciousness, a broken bone, or a head or spinal injury, call 911 now! These problems require immediate attention. Check here if you’re not sure if it’s an emergency or not.

Conditions That Can Be Treated Over the Phone

 Sick Girl Talking on the Phone

Telehealth visits are a good option for many routine health needs – the type of things you’d make an appointment to see your family doctor for, such as:

You can also use telehealth visits to help you manage chronic, or ongoing, conditions, such as:

Eligible patients may be able to have a phone appointment with a dietician or a screening with a dental specialist for dental emergencies.

Be Prepared to Talk About Your Health History

Videocall with Doctor

Because your doctor isn’t able to do a hands-on examination, you should be prepared to give them as much information as you can and describe your symptoms. Your appointment may not be with your usual doctor, so you may need to help the doctor understand your health history.

Be ready to tell your doctor about:

  • Prior or existing conditions (e.g., asthma, diabetes, depression, breast cancer)
  • Previous surgeries
  • If you’re taking prescription or over-the-counter medication
  • If you are currently under the care of another doctor

Make Sure You Can Give Information About Your Health Concern

Woman on Phone Holding Meds

Your doctor can only help you if he understands your concerns. You can help!

Before your visit, write down information about your condition. Think about questions like:

  • Where is your pain or discomfort?
  • What is the pain like – sharp, stabbing, dull?
  • How long have you felt like this?
  • Can you trace your problem back to a certain event – for example, if you came in contact with an allergen, started feeling bad after you ate something, or lifted something heavy?
  • Are there times when it’s better or worse?
  • Have you taken any over-the-counter treatments? If so, what kind and for how long? Did they make you feel better?

Find a Quiet, Private Place to Take the Call

Find a Quiet Private Place to Take the Call

A provider will call you within one-hour of the appointment time or may call you sooner than the appointment time. You may only have a limited amount of time, so make the most of it by finding a spot at home where you can talk freely and without distractions.

Even though your doctor can’t examine you the way they would in an AltaMed facility, they will do their best to find out about your condition. Make sure to wear comfortable, loose-fitting clothing, in case they ask you to roll up a sleeve, turn to the side so they can watch you breathe, or give you other instructions.

You’ll be able to talk with a doctor who speaks your language, but it’s important that you understand what they’re saying. Our doctors want to help, so feel free to tell them, “I don’t really understand what you mean” or ask them to explain things more than once.

After the visit, you can get notes and a summary of the visit at your MyAltaMed patient portal, or if you have not registered for access to MyAltaMed, a paper copy will be mailed to you.

If you need a prescription medicine, we’ll make sure it’s sent over to the pharmacy of your choice.

Need Care? Call Us First!

Mom Calling Doctor for Sick Son

No matter what your health care needs, we’re here to make sure they get handled. Call our Patient Service Center at (888) 499-9303 and we’ll direct you to the right services.

Medi-Cal is Expanding to More Californians