Resources

Medical Information

Click to jump to the following sections:

Online Medical Information
MediCal/Managed Care
Healthy Families
Medicare/Medicaid
Medicare Part D Prescription Drug Plans
Covered California: Affordable Health Care
Pre-Admission Health Information Form for caregivers
Immunization Awareness
Dental Care
HRC Publications: MediCal, California Children's Services, In Home Nursing

Online Medical Information

Click on this link for an on-line medical reference, a search engine sponsored by the U.S. National Library of Medicine and the National Institute of Health, for information on:

  • Health Topics
  • Drug Information
  • Medical Encyclopedia
  • Medical Dictionary
  • Other Resources

MediCal Recipents and Managed Care: Changes in MediCal affecting people with disabilities

Medi-Cal is California’s Medicaid Program. It provides medical, dental, mental health, alcohol and drug use treatment, and vision care to millions of Californians. You can learn more about Medi-Cal at www.dhcs.ca.gov. The State Department of Health Care Services serves MediCal beneficiaries who are seniors and people with disabilities through Medi-Cal Health Care Plans.

Prior to January 2007, most people with disabilities received care through fee-for-service MediCal and only a small percentage were enrolled in managed care. As of January 2007, California re-designed MediCal to expand Managed Care for MediCal beneficiaries In some counties such as Orange County and Santa Barbara, all MediCal beneficiaries including people with disabilities were required to join a managed care plan at that time, while others, including our clients in Los Angeles County had the option to remain in the fee-for-service MediCal.

As of June 2011, managed care was further expanded and, with few exceptions*, all MediCal beneficiaries including people with disabilities must join managed care (1115 Waiver). MediCal beneficiaries who are exempt from joining managed care include those who also have Medicare (dual eligibles), those with other health insurance, those with share of cost MediCal, those who are in ICFs/SNFs, foster children, children who also have CCS and live in Alameda, Los Angeles, and San Diego counties.

*Those who will not be required to join MediCal managed health plans at this time include people who also have Medicare in addition to Medi-Cal (aka Medi/Medi, or dual eligible), people who have private or other health insurance, people with "share of cost" MediCal, people residing in Intermediate Care and Skilled Nursing Care, foster children, and children who also have California Children's Services (CCS) coverage in Alameda, Los Angeles and San Diego counties. long-term care or institutional settings, and people who participate in certain home and community-based waiver programs.

Under the "Two Plan Model" for Managed Care in Los Angeles, beneficiaries can select to join either

  • LA Care Health Plan (LA Care Direct & plan partners are Care First, Blue Cross, and Kaiser Permanente)
  • HealthNet (HealthNet Direct and plan partner is Molina).

Beneficiaries can obtain information and or assistance to enroll by calling

Or log on to Coordinated Care Initiative website, CalDuals, "Keeping you informed about Medicare/MediCal integration."

Changes affecting MediCal beneficiaries with disabilities who also have Medicare (dual eligibles)

Under the California Coordinated Care Initiative (CCI) which is anticipated to be implemented in March 2013, "dual eligibles" are required to join managed care except for "dual eligibles" who are disabled. People with disabilities, however, will have their long terms support services (e.g. IHSS, CBAS) integrated into managed care. (Again, people who live in Intermediate Care will not be affected by this change).

Other anticipated changes: Healthy Families and SSI

  • Beneficiaries of California's Healthy Families Program are scheduled to transition into coverage through MediCal no sooner than January 2013. Families will be contacted by the Department of Health Care Services regarding the change and what they need to do. Benefits are for the most part comparable.
  • Most Supplemental Security Income (SSI)* beneficiaries with Medi-Cal are required to join a MediCal Health Care Plan, including people who are seniors (65 yrs and older), blind, or disabled.

For questions and or assistance pertaining to any of the above changes, pl;ease contact your HRC Counselor. Your Counselor may also call upon HRC's Benefits Specialist and clinicians for additional consultation.

Medicare/Medicaid

The Centers for Medicare and Medicaid Services (CMS) have posted information for individuals regarding health coverage.

  • Healthcare.gov - Information to take health care into your own hands, explore insurance coverage options and learn how the Affordable Care Act impacts you.
  • Medicare.gov - Information for people with Medicare, Medicare open enrollment, and benefits. It provides information on what Medicare covers, Medicare Part D Prescription Drug Coverage, and information on how to sign up or change a plan.
  • The "Caregiver Resource Toolkit" to help family members ensure that their loved ones receive the care they need.
  • InsureKidsNow.gov - Information for children up to the age of 19 in need of health care coverage.

Medicare Part D Prescription Drug Plans

The Medicare Part D program, which is also known as the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) is intended by the federal government to bring more affordable health care, prescription drug coverage to all people with Medicare, expanded health plan options, improved health care access for rural Americans, and preventive care services, such as flu shots and mammograms.

To find a Medicare Part D that is right for you, you can visit their website, enter your medication information, and find out whether it is covered by that plan. You can also provide a list of medications to your HRC Counselor, who can request a review by the HRC Pharmacist.

California Medicare Part D plans with basic benefits and the lowest monthly premiums.

Covered California: Affordable Health Insurance

The new California Health Insurance Coverage plan to make affordable health insurance plans accessible to all goes into effect in January, 2014. Open enrollment period is from October 2013 - March 2014. If you currently have health care coverage through private insurance, or are eligible for MediCal, you can stay with your current coverage. Children may stay on their parents' insurance plan until age 26. Californians who do not already have private insurance or MediCal coverage will be able to shop for affordable coverage from one of 13 available health plans. For more information go to www.coveredca.com.

Pre-Admission Information - A Guide For Care

Click here for the Pre-Admission Health Information Form.
The goal of this form is to help you keep important health history information handy, to provide to hospitals or health care professionals who are not already familiar with the individual, and provide an overview of the person and his/her individual needs. Please consider completing this document in advance of any possible referral to a hospital or other new health care provider, updating it at least annually, and keeping it handy with your records. We hope this information will be useful in case of hospitalization or other unforseen needs.

Immunization Awareness

The National Center for Disease Control offers an information section on its website about vaccination. The site includes facts about particular vaccines, resources, website links, and vaccination schedules for both children and adults. See also its page on vaccine safety concerns.

Some additional helpful references about immunzations include:

Dental Services

The State of California Department of Health Services website also provides a directory of dentists who accept DentiCal, searchable by county, that is updated weekly.

HRC Publications

Check out our publications page for booklets on MediCal, California Children's Services, and In Home Nursing Services