EXPRESS LANE ENROLLMENT

PRESENTED BY

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Express Lane Enrollment Overview

• Pursuant to federal provisions, individuals eligible for CalFresh can use this as their “express” eligibility pathway into Medi-Cal without having to file a separate Medi-Cal application. Eligibility will be established for a 12-month period

• By being enrolled in CalFresh, income and residency have been previously verified.

• Enrollment of individuals that opt for this express enrollment must still undergo necessary citizenship and identity verifications to comply with federal Medicaid regulations.

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Express Lane Enrollment Overview

Targeted populations:

Adults• Approximately

530,000 people

• Aged 19-64 years old

• Currently enrolled in CalFresh

• Do not have health coverage through Medi-Cal, Medicare, or the Low Income

Health Program (LIHP).

Children• Approximately

150,000 people

• Below age 19

• Currently enrolled in CalFresh

• Do not have health coverage through Medi-Cal or Medicare

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CalFresh Express Eligibility Process and Timeline

On February 3rd, 2014, notices began to be sent to the target population of adults informing them that they can enroll in Medi-Cal. About 530, 000 individuals.

Notices are scheduled to be sent to the child population beginning on February 20th, 2014. About 150,000 individuals.

In counties where there is more than one managed care plan available, this letter will also include a health plan selection form.

For the period covered by the federal waiver, eligible CalFresh recipients will be given express lane eligibility.

A Modified Adjusted Gross Income (MAGI) Medi-Cal determination will be done at the end of the 12 month period or in the case of a change in circumstance. 4

Express Lane Affirmation Process

Affirmation Notices are being sent to identified populations

Individuals that receive the notices may respond by means of phone, mail or website

Eligible individuals with active CalFresh cases (that meet age eligibility requirements) may request Express Lane at the county welfare department

County Express Lane Functionality

Counties will be able to service cases; complete address changes and Issue Benefits ID Cards.

Counties will be able to enroll individuals who present Express Lane Affirmation Notices to them.

Counties will be able to enroll individuals with active CalFresh cases that meet the age requirements.

Response

65,148 individuals enrolled as of last Friday

Next Steps for Express Lane Enrollment

The following individuals will be targeted for future express lane eligibility efforts:

Eligible, but not enrolled parents with incomes not exceeding 138 percent of the federal poverty level who have children enrolled in Medi-Cal

Other potential populations are being considered for Express Lane Enrollment

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Express Lane Enrollment Contact Information

DHCS Contacts: Jeff Baca and Crystal Haswell

Direct questions regarding the Express Lane Project to:

medi-cal2014@dhcs.ca.gov

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CCHI Assister’s Corner: A webpage designed to keep assisters up to date on outreach and enrollment issues and host the latest information to support your role in enrolling children and families into affordable coverage.

http://cchi4families.org/assisterscorner/

ELE Frequently Asked Questions in English and Spanish available

DHCS Express Lane Resource page includes all notices/letters and information on the Federal guidance:

http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/ExpressLane.aspx

Express Lane Enrollment Resources