Written by Jaimie Oh
Under proposed rules for California’s Medi-Cal program, patients would have to share costs to fill prescriptions, see their physician or visit the hospital, according to a Clovis Independent news report.
The proposed plans, which must be submitted for approval by the federal government, also include a 10 percent cut to physician reimbursement and caps on physician office visits to only seven each year. Although state officials are proposing the changes to help balance the state’s budget, healthcare providers argue the change could lead to higher healthcare costs since most beneficiaries would likely hold off on seeking medical attention, according to the news report.
According to the news report, savings from the proposed change in co-pay would amount to $511 million and the proposed 10 percent cut to physician pay would amount to another $614 million. State officials have already submitted the proposal for additional co-payments and plan to submit the other proposals in a few days.
Meanwhile, state officials have also expanded managed care under the Medi-Cal program in efforts to better coordinate care and control costs. Approximately 400,000 California residents, mainly older or disabled individuals, will be moved to a managed care plan. Although a majority of Medi-Cal beneficiaries are already in managed care plans, the older and disabled populations were typically not included.
Services Covered by Medi-Cal include:
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Depending on monthly income, some adults may qualify for “no cost” Medi-Cal which means they can receive benefits for free. They are not required to make co-payments for services or monthly payments to keep their coverage. Adults who qualify for “share of cost” Medi-Cal are required to meet a monthly amount of payments for their coverage, in addition to $1 co-pays for some services.
Judd Matsunaga of Elder Law Services is a qualified attorney who has helped hundreds of California residents with Medi-Cal Planning. Mr. Matsunaga can be reached for a free consultation by calling 1-800 403-6078.