Cal MediConnect definition

Cal MediConnect means the Centers for Medicare & Medicaid Services (CMS) and the State of California's three-year demonstration project to promote coordinated health care delivery to seniors and people with disabilities who are dually eligible for both of the State Medi-Cal program and the federal Medicare program;
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Cal MediConnect means the State Medi-Cal program and the federal Medicare program are partnering to launch a three-year project to promote coordinated health care delivery to seniors and people with disabilities who are dually eligible for both of the public health insurance programs, “dual eligible beneficiaries.” It will be implemented no sooner than April 2014 Los Angeles. The Cal MediConnect program aims to improve care coordination for dual eligible beneficiaries and drive high quality care that helps people stay healthy and in their homes for as long as possible. Additionally, shifting services out of institutional settings and into the home and community will help create a person-centered health care system that is also sustainable.
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Cal MediConnect is a program to furnish health care services to Members who are dually eligible for Medicare and Medi-Cal and enrolled in CalOptima’s Cal MediConnect program. Cal MediConnect is also referred to in this Contract as “OneCare Connect.”
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Examples of Cal MediConnect in a sentence

  • L.A. Care Cal MediConnect Plan– L.A. Care Cal MediConnect Plan provides coordinated care for Los Angeles County seniors and people with disabilities who are eligible for Medicare and Medi-Cal.

  • Beneficiaries may opt out of the Cal MediConnect program at any time.

  • Beneficiaries who opt out of Cal MediConnect, will remain in their existing Medicare program and be enrolled in a Medi-Cal managed care plan for coverage of their Medi-Cal benefits, including LTSS.

  • Enrollment is described in the plan-specific three-way contracts signed by CMS, the State, and the Cal MediConnect plan.

  • Medi-Cal and Cal MediConnect members have no out-of-pocket costs for covered services.

  • The State shall report to CMS on the assessment of the Cal MediConnect Independent Consumer Supports program and incorporate efficient processes and lessons learned into the CCI Consumer Supports program.

  • Dual eligibles who opt out or are excluded from the Cal MediConnect program, and Medi-Cal only SPDs who were previously excluded from the SPD mandatory enrollment program will be mandatorily enrolled into a Medi-Cal managed care plan The enrollment may be tailored for each county as appropriate to address the specific demographics and population of each county.

  • Effective no sooner than April 1, 2014, according to the schedule described in Attachment U, dependent on the effective date of the 3-way contract, the State may begin enrollment of beneficiaries eligible for the Cal MediConnect program.

  • The Cal MediConnect Ombuds Program works as an advocate on your behalf.

  • The age range for DualChoice Cal MediConnect Plan (Medicare – Medicaid) line of business are Ages 21 and above.

Related to Cal MediConnect

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