For the first time since the COVID-19 pandemic began, California will resume its normal processes to redetermine eligibility for Medi-Cal enrollees starting in April 2023. It will be imperative to help many of these Californians transition to other types of coverage and to ensure that those who remain eligible keep their Medi-Cal coverage.
If you are a Medi-Cal enrollee who has moved or changed phone numbers since 2020, make sure to update your contact information with Medi-Cal. Go to KeepMediCalCoverage.org or contact your local Medi-Cal office. You can also call the Medi-Cal Member Helpline at (800) 541-5555. Be on the lookout for mail from Medi-Cal in the coming months and respond promptly. If you need help, contact the the Health Consumer Alliance.
During the COVID-19 pandemic, states received increased Medicaid funding on the condition that they would postpone disenrollments as long as the federal COVID-19 public health emergency (PHE) remained in effect. This “continuous coverage” requirement allowed millions of Californians to stay on Medi-Cal during an unprecedented health crisis.
The federal Consolidated Appropriations Act of 2023 specified that the Medicaid continuous coverage requirement would no longer be linked to the PHE. The requirement ends on March 31, 2023.
Starting April 1, 2023, Medi-Cal will resume its normal renewal processes over the subsequent 14 months, redetermining eligibility for around 15 million current enrollees. It’s estimated that during this “unwinding period,” two to three million Californians may leave the program. The vast majority will be eligible for other types of coverage but may need help transitioning. Many Californians who remain eligible for Medi-Cal are at risk of getting disenrolled from the program simply due to administrative or procedural barriers, such as Medi-Cal eligibility offices lacking enrollees’ current addresses after the last two tumultuous years.
This collection highlights recommendations and tools to help the state and key partners navigate the unwinding period while minimizing disruptions to Californians’ access to care and coverage.
In addition to the resources below, see Covered California’s Auto Enrollment Toolkit (available on this page under “Toolkits for SB260”). Soon after the federal continuous coverage requirement ends, Covered California will begin automatically notifying and completing plan selection for Californians who lose Medi-Cal coverage if they are eligible for a subsidized plan on Covered California. The toolkit provides more information for consumers and enrollment partners.
SCAN Foundation: PHE Flexibilities Roadmap for Policymakers
Experts representing insurer, consumer, and provider perspectives developed recommendations for federal and state policymakers on which Medicare and Medicaid public health emergency (PHE) flexibilities should be made permanent because they increase equitable, person-centered care for older adults.
DHCS: Keeping Medi-Cal Beneficiaries Covered
This one-stop shop from the California Department of Health Care Services (DHCS) provides key resources and information for all who want to help keep Californians covered after the end of the public health emergency (PHE). It includes information on its Coverage Ambassadors program and the Medi-Cal continuous coverage toolkit.
DHCS: Medi-Cal COVID-19 PHE Operational Unwinding Plan
This plan provides a comprehensive view of the California Department of Health Care Services’ (DHCS) plan to “unwind” the flexibilities implemented over the course of the COVID-19 public health emergency (PHE), including the resumption of normal Medi-Cal eligibility operations.