The Kaiser Medi-Cal Situation

Posted on June 25th 2017 in General, Medi-Cal

by Jane Jetter, Operations Manager

Jane Jetter

June 25, 2017

The largest benefactor among California insurance companies from the Medicaid (or Medi-Cal) expansion by the Affordable Care Act is the Kaiser Permanente plan. With its tightly controlled cost structure, the care that so many eschewed when it one of the most expensive has now become sought after by existing and former Kaiser members. To be true, the care Kaiser now delivers is vastly improved over its previous iterations. I use Kaiser and although you must be your own advocate in its system, the service is good and in some situations exemplary.

It is possible to return or keep Kaiser once someone becomes eligible for Medi-Cal but there are certain steps that must be taken before you can use a Kaiser Medi-Cal policy.

Kaiser has made it as easy as they can by listing those steps here. That would seem simple enough, but there are some other things to consider:

Kaiser Medi-Cal is not available to all Medi-Cal recipients. To be eligible for Kaiser Medi-Cal, you must have been previously enrolled in Kaiser within certain time frame. The time frame is different in each county. Minors are automatically eligible if their parents have an existing Kaiser plan or have been enrolled during the time frame.

Until you cancel your paid Kaiser plan, you will not be eligible for Kaiser Medi-Cal.

Once you are officially enrolled in a Kaiser Medi-Cal plan, you can see your regular Kaiser doctor or get your prescriptions from them. Until then you must use approved county facilities. In the case of an emergency, Federal law mandates that you can use any hospital emergency room.