The Future of Cal MediConnect
On January 1, 2023, all Cal MediConnect Plans (CMC) will transition into matching Medicare and Medi-Cal plans operated by the same company. Your patients’ current MMP plan will change to a new, exclusively aligned D-SNP Plan. Patients do not need to do anything to remain with their current plan.
Patients will receive two notices prior to the January 1, 2023 transition date. A 90-day notice will be sent around October 1st, and a 45-day notice will be sent mid-November.
If your patients have any questions about the transition, please have them contact Member Services. Their Member Services phone number is located on the back of their plan ID Card. It is important for your patients to know that no action is needed by them for the D-SNP transition.
What is Cal MediConnect?
Cal MediConnect is a program that integrates medical care, long-term care, mental health and substance use programs and social services under a coordinated care plan for people who are dually eligible for Medicare and Medi-Cal. CareMore accepts both Anthem Blue Cross Medicare-Medicaid Plan (MMP) and L.A. Care Cal MediConnect as part of this program.
Visit duals.anthem.com for more information.
What is the Goal of Cal MediConnect?
The Cal MediConnect program's goal is to keep seniors and people with disabilities healthy and remain at home and in their communities as long as possible by delivering coordinated and patient-centered care, including Long-Term Services & Support through a system that is easy to navigate. Under this model, both beneficiaries and providers will experience a streamlined process: One team. As a CareMore Health provider, you are plugged into your CareMore Health Patient’s Care Team – along with all their other providers, case managers, in-home caretakers and family – and kept up-to-date on treatment plans and services for each of your CareMore Health patients. If you have questions about anything, you know you can turn to us.
One plan. Patients get almost all their Medicare and Medi-Cal benefits from one health plan, meaning fewer administrative headaches for your staff and less confusion for our patients.
Who is Eligible for Cal MediConnect?
Cal MediConnect is available to individuals who meet all of the following criteria:
- Age 21 and older at the time of enrollment
- Entitled to benefits under Medicare Part A and enrolled under Medicare Parts B and D
- Eligible for full Medi-Cal benefits
- Reside in Los Angeles and Santa Clara counties
How do My Patients Join CareMore Health Cal MediConnect?
Provider Manual-Cal MediConnect Addendum
The Provider Operations Manual contains guidelines, policies and procedures and general reference information required of our providers to ensure that members receive quality, comprehensive care. The Provider Operations Manual includes a Cal MediConnect Addendum that covers specific Cal MediConnect requirements.
Should you have general questions pertaining the Provider Manual, please contact Provider Relations at 888-291-1358 (select Option 1 & Option 5).
To download a copy of the current Operations Manual located on our Provider Portal in Documents/General Reference Documents, 2021 folder, 2021 Provider Operations Folder.
Provider Portal | CareMore Health