9005 - Active Medi-Cal Recipient - Out-of-State Per SSA Buy-In - Priority Alert

This alert is generated to advise the EW that according to SSA in Baltimore, this recipient has moved out of California. MEDS shows this recipient is currently active.

The alert has triggered an automatic action in CalSAWS to update the Collect Individual Residency Detail window and discontinue the recipient’s Medi-Cal eligibility.

Sample Alert

Click herehere to view the sample alert.

Possible Screens To Resolve This Alert

ReviewReview INQ1 screen for eligibility information:
ReviewReview INQB for Buy-In Information:

The Buy-in Status Code indicates out-of-state deletion. Refer to Chapter 12, MEDS/CDB Data Element Dictionary, STATUS for a list of Buy-In Status Codes.

Action Required

The EW must verify the recipient’s residency and take the following action:

If the recipient moved out of state, review the Residency Detail and EDBC Results pages to ensure Medi-Cal is properly discontinued by the automatic action.
- If YES, no further action is required.
- If NO, update the Residency Detail page by changing the CA Resident [Y/N] field to ‘N’ and run EDBC.
If the recipient DID NOT move out of state, refer the recipient to the local SSA office for resolution. Also contact State Medicare Buy-In Unit to restore Buy-In for the recipient, if necessary.

Refer to MC HB Chapter 5: Medicare Coverage, Section State Medicare Buy-In Problem Form for additional details on Medicare Buy In unit.

9005 - Active Medi-Cal Recipient - Out-of-State Per SSA Buy-In - Priority Alert

Sample Alert

Possible Screens To Resolve This Alert

Action Required

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