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DPSS ePolicy

MEDI-CAL

Full Scope Medi-Cal for Children and Young Adults

Release Date
01/02/2020

Section Heading

Purpose

To convert existing policy to new webpage – No content changes


What changed?

Effective January 1, 2020, full scope Medi-Cal (MC) has been expanded to young adults between the ages 19 to 25 who do not have satisfactory immigration status or are unable to verify their United States citizenship, if all other eligibility criteria is met.  The impacted populations are:

  • New Enrollee Population:  The new enrollee population are young adults ages 19 through 25, who are not enrolled in MC but meet all eligibility criteria for the program except for satisfactory immigration status.
  • Transition Population:  The transition population consists of young adults ages 19 through 25, who are currently receiving restricted scope MC.  The transition population also includes beneficiaries receiving full scope MC under Senate Bill (SB) 75, who would have aged out of their full scope coverage at age 19, and lawfully present immigrants, who would have aged out of their full scope coverage at 21.  These individuals will transition to full scope MC beginning January 1, 2020.

 


Policy

Effective May 1, 2016, all children under the age of 19 are eligible to receive full scope MC benefits regardless of their immigration statusEffective January 1, 2020, all young adults between 19 and 25 years of age are eligible to receive full scope MC benefits regardless of their immigration status if otherwise eligible.

MC benefits for undocumented children under 19 and young adults between 19 and 25 years of age are no longer limited to emergency and pregnancy related services.

Once receiving full scope MC, all beneficiaries from newborn to 25 years of age, regardless of their immigration status, are required to enroll in a Managed Care Health Plan.


Background

On June 24, 2015, SB 75 was signed into law, which provided full scope MC benefits to all eligible children under the age of 19, regardless of citizenship, alienage or immigration status.

Senate Bill (SB)104 (Chapter 67, Statutes of 2019), amended Welfare and Institutions Code Section 14007.8 to expand full scope MC to the young adult population, ages 19 through 25, who do not have satisfactory immigration status or are unable to establish satisfactory immigration status or unable to verify United States citizenship.  The Young Adult Expansion is modeled after the coverage provided by SB 75 (Chapter 18, Statutes of 2015) as amended by SB 4, (Chapter 709, Statutes of 2015) which provided full scope to MC eligible children under the age of 19. 

Full scope MC includes medical, vision, dental, mental health, and alcohol and drug treatment services.

For simplicity, children under 19 and young adults between 19 and 25 will be referred to as “children and young adults under age 26” when mentioned together throughout this document.


Definitions

Terms and Descriptions


SB 75 Population 

Children from newborn up to, and including, the age of 18 years without satisfactory immigration status.


SB 104 Population

Young adults from 19 years of age up to, and including, the age of 25 years without satisfactory immigration status.


California Healthcare Enrollment, Eligibility and Retention System (CalHEERS)

The automated system managed at the State level, which contains the business rules engine used to evaluate eligibility for Modified Adjusted Gross Income (MAGI) MC and programs offered by Covered California.


Statewide Automated Welfare System (SAWS)

County system(s) used to determine eligibility and benefit determination, enrollment, and case maintenance for some of the different health and human services programs (including MC, California Work Opportunity and Responsibility to Kids [CalWORKs], and CalFresh).


Satisfactory Immigration Status (SIS) 

For MC purposes, means lawful admission for permanent residence in the United States, status as an alien permanently residing in the U.S. under color of law, or status as an amnesty alien.


Permanently Residing Under Color of Law (PRUCOL)

It is not an immigration status or a path to citizenship; rather, it is a public benefits eligibility category through which certain undocumented immigrants can apply for Medicaid.


Reasonable Opportunity Period (ROP)

A period of 98 days from application date to allow applicants and/or beneficiaries to submit verification of citizenship or satisfactory immigration status.


Federal Data Hub (FDH)

Electronic verification system used to compare and verify information with other federal and State systems.


Fee For Service (FFS)

MC delivery system where health care providers are paid for each service (e.g., an office visit, test, or procedure).


Requirements

Implementation of SB 75 and SB 104

  1. SB 75 – for children under 19 years of age started on May 16, 2016.

  2. SB 104 – for young adults 19 to 25 years of age is scheduled for January 1, 2020.

Impacted Population

Children and young adults impacted by the implementation of SB 75 and SB 104 have been divided into two groups:

  1. Transition population – children and young adults under age 26 without satisfactory immigration status currently receiving restricted scope MC.

  2. New enrollee population – children and young adults under age 26 without satisfactory immigration status not enrolled in MC.

Application Process

Children under 19 years of age who apply for MC after the implementation of SB 75 on May 16, 2016, must be approved for full scope benefits beginning the application month.

Young adults between 19 and 25 years of age who apply for MC after the implementation of SB 104 on January 1, 2020, must be approved for full scope benefits beginning the application month, if otherwise eligible.

Retroactive Coverage

For children under 19 years of age, requests for retroactive coverage for any of the three (3) months prior to implementation of SB 75 (February, March, April 2016), were evaluated for restricted scope benefits.  Requests for retro coverage for the month of May 2016 forward, were evaluated for full scope benefits.

For young adults between 19 and 25 years of age, requests for retroactive coverage for any of the three (3) months prior to implementation of SB 104 (October, November, December 2019), should be evaluated for restricted scope benefits.  Requests for retroactive coverage for months beginning January 2020, forward, should be evaluated for full scope benefits.

Transition Process

Children under 19 years who were receiving restricted scope MC at the time of SB 75 implementation were automatically transitioned into full scope MAGI or Non-MAGI aid codes on May 16, 2016.

Young adults between 19 and 25 years who are receiving restricted scope MC at the time of SB 104 implementation will be automatically transitioned into full scope MAGI or Non-MAGI aid codes on January 1, 2020.

MC Managed Care Enrollment

Children and young adults under age 26 who transitioned from restricted scope MC to full scope MC as a result of the implementation of SB 75 or SB 104 are required to enroll into a MC Managed Care Health Plan with the following exceptions:

  1. Children who turned 19 from May through October 2016 (the first six (6) months of the implementation of SB 75) were not required to enroll in a Managed Care Health Plan but could have enrolled voluntarily.

    Example – Child turned 19 on July 30, 2016 
    On May 16, 2016, the date of the implementation of SB 75, this child was transitioned from restricted scope to full scope benefits but his/her enrollment into managed care was voluntary.


  2. Young adults who will turn 26 within the first six (6) months of the implementation of SB 104 (January through June 2020) are not required to enroll in a Managed Care Health Plan but may do so voluntarily.

    Example – Young Adult turns 26 on May 30, 2020
    On January 1, 2020, the date of the implementation of SB 104, this young adult will be transitioned from restricted scope to full scope benefits but his/her enrollment into managed care is voluntary.

Individuals being transitioned to full scope on January 1, 2020, who are not turning 26 from January to June 2020, will be placed in Fee-For-Service (FFS) full scope MC for up to two (2) months to allow them enough time to select a plan, but they must select a plan by the end of the second month.

If a plan is not selected by the end of the second month, the State will automatically assign a plan for the child or young adult.

Report Changes Within 10 Days

MC applicants and beneficiaries must report any changes to the citizenship or immigration status of any family member who is applying for or receiving MC to their Eligibility Worker (EW) within 10 days.


Verification Docs

MC 13 - Statement of Citizenship, Alienage, and Immigration Status

The MC 13 form is not required for individuals self-attesting U.S. citizenship/SIS and whose citizenship or immigration status is electronically verified with the HUB.  The MC 13 is a mandatory form for all individuals whose immigration status cannot be electronically verified or for those claiming Permanently Residing Under Color of Law (PRUCOL) status under category 16.


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APP
Pre Apprenticeship Certificate Program
AU
Administratively Unemployable
CLA
Clinical Assessment Appointment
CLE
Clinical Engagement
CORE
Career, Opportunities, Resources and Employment
CSS
Department Of Community And Senior Services
CSSD
Child Support Services Department
DMH
Department Of Mental Health
EJS
Early Job Search
ELAAJCC
East Los Angeles America’s Job Center Of California
ES-EW
Employment Special Eligibility Worker
HiSEC
High School Equivalency Certificate
HiSET
High School Equivalency Test
JOC
Job Order Coordinator
JRT
Job Readiness Training
JSPC
Job Skills Preparation Class
LACOE
Los Angeles County Office of Education
LADOT
Los Angeles Department of Transportation
LOD
Line Operations Development
NSA
Need Special Assistance
PCC
Pasadena City College
REP
Rapid Employment Promotion
SIP
Self-Initiated Program
SOA
Security Officer Assessment
SOT
Security Officer Training
SSVF
Supportive Services for Veteran Families
TAP
Transit Access Pass
VA
Department of Veteran Affairs
VL
Veteran Liaison
WIOA
Workforce Innovation & Opportunity Act

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