04/11/2023: Medi-Cal Redetermination.

During the COVID-19 Public Health Emergency, the federal government paused Medicaid eligibility verifications. This process is known as redetermination. Roughly 13 million Medi-Cal members stayed enrolled during this time without re-certifying their eligibility. Now, the state of California is resuming this requirement, starting April 1, 2023.

Please talk with your Medi-Cal patients about taking the steps below:

• Update their contact information – Make sure their mailing address, phone number and email address are current.
• Los Angeles County members can update their information by calling the Los Angeles County Department of Public Social Services at 1-866-613-3777 (TTY) 1-800-660-4026, or by going to benefitscal.com or visit KeepMediCalCoverage.org for more information and to sign up for text or email updates on Medi-Cal renewals.
• Orange County members can update their information by calling the County of Orange Social Services Agency at 1-800-281-9799 or by going to MyBenefitsCalWIN.org
• Sign up for updates – Create or check their online account to get general updates about Medi-Cal renewals through email and text messages.
• Check their mailbox – Look out for a letter from the local county office about their Medi-Cal coverage. If they get a renewal form, fill it out and return it right away by mail, phone, in person or online.

Below are links to the CalOptima (English, Spanish, and Vietnamese) and Health Net (currently English only) member facing Flyers regarding Redetermination.

• CalOptima Redetermination-English
• CalOptima Redetermination-Spanish
• CalOptima Redetermination-Vietnamese
• Health Net Redetermination for Provider
• Health Net Redetermination for Member
• LA Care Redetermination Provider Poster

02/09/2023 Specialist Term Requirements

Specialists are reminded they are contractually required to inform the IPA of the intent to Terminate with at least 90 days advanced notice in writing following the terms of the contract with the IPA. Please contact your provider services representative for any questions.

07/05/22: The Medi-Cal Rx Pharmacy Benefit took effect on 01/01/2022. In addition to medications and vaccines, Medi-Cal Rx covers other products. Listed below are hyperlinks to the various covered products:

• Covered Personal Blood Pressure Monitoring Devices and Blood Pressure Cuffs
• Covered Enteral Nutrition Products
• Covered Diabetic Test Strips and Lancets
• Covered Disposable Insulin Delivery Devices
• Covered Self-Monitoring Blood Glucose Systems (Glucometers), Control Solutions, and Lancing Devices
• Covered Therapeutic Continuous Glucose Monitoring (CGM) Systems
• Covered Pen Needles
• Covered Sterile Syringes with Needles
• Covered Medical Supplies Product Descriptions and Billing Information

We encourage you to review the Medi-Cal Rx website for reference materials and training. You may also contact the Medi-Cal Rx Customer Service Center toll-free number: 1-800-977-2273, available 24 hours a day, 7 days a week, 365 days per year. MedicalRxEducationOutreach@MagellanHealth