Medi-Cal Update 2023-6 Covered CA Automatic Plan Enrollment

Covered California Automatic Plan Enrollment

Date References Clerical Handbook(s) Revised
5/9/2023 ACWDL 2022-20 No MCHB Chapter: 2

Background

Senate Bill (SB) 260 requires Covered California (Covered CA) to automatically enroll qualified individuals transitioning from Modified Adjusted Gross Income Medi-Cal (MAGI MC), the County Children’s Health Initiative Program (CCHIP), the Medi-Cal Access Program (MCAP) and the Medi-Cal Access Infants Program (MCAIP) into the lowest cost Silver Covered California health plan available before their current coverage ends.

Changes

To meet SB 260 auto-plan enrollment, discontinued MAGI MC beneficiaries must be eligible or conditionally eligible for Advanced Premium Tax Credit (APTC) and include the following:

  • MAGI Medi-Cal beneficiaries who have household income increases and/or family size changes making their income above the MAGI Medi-Cal limits or children who have aged out; and beneficiaries not eligible to Consumer Protection Programs (CPPs), or
  • Children enrolled in CCHIP who have aged out or moved out of CCHIP counties, or their family income increases making their household income above the CCHIP limit, or
  • MCAP individuals who are no longer eligible for MCAP.
  • MCAIP infants with household income increases at their first annual renewal or upon reaching age 2.

 

The following Medi-Cal Handbook section has been updated: Automatic Plan Enrollment in Covered CA

Implementation

The guidance in this Update begins when counties start processing June 2023 Medi-Cal renewals.

Note: Negative actions must be delayed on Medi-Cal cases until their scheduled renewal month during the Continuous Coverage Unwinding period.

Forms

Covered CA will send qualified individuals the following notice "Covered California Eligibility Notice for Medi-Cal transitioning individuals" (NOD01T). The notice will provide the Covered CA case number, name of the selected health plan, monthly premium amount, financial help amount and the actions the individual will need to take to start coverage.

 

Supervisors

Please share this Update with staff at your next unit meeting.

Angela Shing, Director
Department of Employment & Benefit Services
Contact Person(s): Erica De La Pena, Application and Decision Support Specialist I, 408-755-7540.