Switching Physicians With Medi-Cal Insurance: A Step-By-Step Guide

If you have Medi-Cal insurance and want to change doctors, you can do so by selecting a new primary care physician (PCP) from a list of covered medical providers. As a Medi-Cal member, you have access to member services just like anyone with a private insurance plan. You can access these services online through your plan's website or by phone.

Changing your Medi-Cal plan

Once you've decided on a new plan, you can switch at any time. There are a couple of ways to do this. You can call Medi-Cal Managed Care Health Care Options on their helpline: 1-800-430-4263. Alternatively, you can complete a Medi-Cal Choice Form, which can be found on the Health Care Options download page. Simply select your county from the drop-down menu and look for the form link under "Choice enrollment forms".

If you need to cancel your Medi-Cal coverage, you should call your local county office. Once you are released from Medi-Cal, you can get a quote online to view rates and enrol in a Covered California plan. It's worth noting that there are different income limits for Medicaid/Medi-Cal and Covered California.

Cancelling your Medi-Cal coverage

To cancel your Medi-Cal coverage, you can either fill out a form or contact your local county office.

Cancelling Medi-Cal by Form

You can download a request for withdrawal form from the California Department of Healthcare Services website. When filling out the form, you need to provide the reason for your withdrawal application. For example, if you're starting a new job and will be insured by your employer, you may want to cancel your Medi-Cal coverage immediately. Once you've completed the form, you'll need to submit it at your local county office in person.

Cancelling Medi-Cal by Contacting Your Local County Office

Call your local county office and explain that you want to withdraw from Medi-Cal. A social worker will set up a meeting and tell you what information to bring to withdraw your application. You can find contact information for your local county office on the California Department of Health Care Services website.

Applying for New Health Insurance

Once your Medi-Cal coverage is discontinued, you only have 60 days from the date it ends to start new health insurance. To avoid being uninsured, your new plan must start before your Medi-Cal plan ends. Check the dates carefully on the Notice of Action you receive. You can apply for a new plan through Covered California, either online or over the phone.

Accessing your member services

As a Medi-Cal member in California, you have access to member services in the same way as anyone with a private insurance plan. As a member, you can access your member services online through your insurance plan's website and the Covered California website. Each service manages different aspects of your coverage. Your local county office will also handle specific parts of your Medi-Cal membership.

Your health insurance company will manage the following:

• Premium payments: Your health insurance company will accept premium payments online or by phone.
• ID cards: Your insurance company will issue your membership ID card and send a replacement if you lose it.
• Benefits and eligibility: A representative from your insurance company can explain the unique benefits and eligibility requirements of your insurance plan.
• Claims: The insurance company can inform you of how you paid your service claims for verification purposes.
• Covered medical providers: Your plan's company can help you find a covered medical provider or change your primary care physician.

Covered California manages the following:

• Enrollment: You can determine your eligibility for a special enrollment period, learn when you can enroll, or enroll in a Medi-Cal plan through Covered California.
• Application information: Covered California handles changes to application information such as income verification, proof of residency, and citizenship.
• Eligibility: When you request a quote from Covered California, they will determine if you or a family member is eligible for Medi-Cal.
• Coverage cancellation: If you want to cancel your Medi-Cal plan, you can request this through Covered California.
• Changing to a private plan: You can enroll in a private plan through Covered California if you will soon lose your Medi-Cal coverage.

To access member services, you can go online or do it over the phone. Most insurance plans offer online member assistance, and many companies also allow you to call them for direct help. Covered California also provides online member services that you can access through your account. You can make a Covered California account even if you have already submitted an application through another method.

Paying your premium online

If you need assistance with the payment process, your insurance company can help. They can be contacted online or by phone, and they will be able to answer any questions you may have about paying your premium.

Additionally, Covered California provides valuable information on its member information website. Here, you can find details about each plan's payment options, which can help guide you in choosing the best payment method for your needs.

Remember, it is essential to make timely payments to ensure uninterrupted access to your healthcare services.

Checking your Medicaid status

To check your Medicaid status, you can do so online, over the phone, or in person at your local Medicaid office. Here are the steps you can take:

• Set up an online account if you haven't already. Even if you applied for Medicaid in person or over the phone, you can still use your state's website to manage your account or check your status. Go to your state's Medicaid website and look for an option to register or sign up.
• You will need an email address to set up an online account. Your state Medicaid office will use that email address to communicate with you about your benefits and account status.
• Create a password for your online account. Pick something memorable but hard to guess.
• Log in using your user ID and password. After setting up your account, the website will likely send you an email to verify your email address. Open the email and click the link to verify, then log in.
• Click on the appropriate link to check your application status. This may be found on the homepage, under account management tools, or in a drop-down menu.

Calling Your State Medicaid Agency:

• Gather your case number or other identifying information. Before a caseworker will discuss your application, they will need to verify your identity. This may include providing a case number or the last four digits of your Social Security number.
• Find your state agency's toll-free number. Each state has a toll-free number you can use to apply for Medicaid or check your status. These numbers are usually available 24/7.
• Call the number and follow the prompts. Listen carefully and select the option to check your application status. If you're unsure, choose an option to connect with a caseworker directly.
• Ask about the status of your application. If you want to speak to a caseworker, it's best to call during regular business hours. They may be able to tell you if any additional information is needed to process your application.

Visiting a Local Medicaid Office:

• Locate the nearest office. Medicaid is typically administered by county, so there is usually one office per county. Call the office nearest to you to find out if you need an appointment and what to bring with you.
• Go to the office during regular business hours. It's best to schedule an appointment if possible. Bring identification, your Medicaid case number (if you have one), and a pen and paper to take notes.
• Talk to the caseworker about your application status. They can verify your identity, bring up your case file, and answer any questions you have about the application process. Write down the name of the caseworker and ask for direct contact information if possible.

Checking Your Medi-Cal Status in California:

If you are a Medi-Cal member in California, you can check your Medicaid status by contacting your local county social services office. The California Department of Health Care Services has a full directory of each county's agency.

Frequently asked questions