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DPSS ePolicy

MEDI-CAL

Accelerated Enrollment

Release Date
02/08/2022

Section Heading

Purpose

To convert existing policy to the new webpage - No content changes


The purpose of this document is to provide policy changes regarding Accelerated Enrollment (AE).

What changed?

Expansion of AE to adults eligible to Modified Adjustment Gross Income (MAGI) Medi-Cal (MC) who apply via Covered California (CoCA) only. 


Policy

AE is fee-for-service, full-scope, no-cost MC for children under age 19 and adults who submit an application via the CoCA online portal and are eligible to MAGI MC based on self-attestation.  The State grants AE via CoCA.  AE is temporary and has a 60-day maximum period of eligibility.  During this temporary period, the County of residence must make a final eligibility determination for MC benefits. 


Background

On July 1, 2002, the Department of Health Care Services (DHCS) received federal approval of a State plan amendment to implement an AE Program.  AE supports the continuing goals of DHCS to remove barriers and improve access to health care.  The cost of services provided during the AE period is covered under Title XIX. 

Effective July 1, 2021, the expedited enrollment process established for children known as AE has been extended to adults who submit applications through the CoCA online portal but are pending verifications. 


Definitions

Terms and Descriptions


Covered California

California’s health care exchange which allows individuals to apply for health insurance affordability programs.  Users can create an account to apply for health care, enroll in coverage, and report changes for their CoCA plan and/or MC case. 


CalHEERS 

The system used by CoCA to process health care applications and health care plan selection. 


Ex-Parte 

The process of reviewing all information available to the County that is relevant to determine MC eligibility.  This includes reviewing the CalSAWS, Medi-Cal Eligibility Data System (MEDS), and Income and Eligibility Verification System (IEVS) abstracts without contacting the applicant to request verification/documents. 


Federal Data Service Hub (FDSH) 

The electronic verification system that is used to compare and verify information with other State and federal systems during the eligibility determination process. 


MEDS Renewal 

The process on MEDS that updates changes from the current calendar month to the next (future) calendar month of eligibility. 


Requirements

Children and adults who are found AE eligible will be entitled to fee-for-service MC until an MC eligibility determination is established by County eligibility staff.  The following chart details AE requirement guidelines: 

AE Eligibility Requirements


Children (under age 19) or adults (age 19-64) who meet all of these requirements are eligible to AE and are placed in the existing full scope aid code 8E on MEDS: 

  • New applicant; 
  • Eligible for MAGI MC based on self-attested information but are pending verifications, such as State residency, Social Security Number, immigration status, and income; and 
  • Applying through the CoCA online portal. 

Children (under age 19) or adults (age 19-64) who meet any of the following conditions are not eligible to AE:  

  • MC approved on MEDS in the current or future month; 
  • Not California residents; 
  • Ineligible to MAGI MC during CoCA screening; 
  • Age 65 or older in the application month; or 
  • Reported as deceased on MEDS. 

Verification Docs

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Index

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Administratively Unemployable
CLA
Clinical Assessment Appointment
CLE
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CORE
Career, Opportunities, Resources and Employment
CSS
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CSSD
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DMH
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ELAAJCC
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ES-EW
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HiSEC
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HiSET
High School Equivalency Test
JOC
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JRT
Job Readiness Training
JSPC
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NSA
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PCC
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REP
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Self-Initiated Program
SOA
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Security Officer Training
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Transit Access Pass
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Department of Veteran Affairs
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