ࡱ> XZW#` &bjbjmm 48bbbbbbb\\\\x$ *>:(=======$d?hA=b  =bb=111 (bb=1 =11bb1 \0*1==0*>1vB91FvB1vBb1 N1 ==1*> x xv4"bbbbbb Medi-Cal Update from San Diego Regional Center Cambios Importantes a Medi-Cal Mensaje del director de SDRC Carlos Flores, Executive Director Communicator - Spring 2011 California has received a new Medicaid waiver from the federal government which is expected to allow many more individuals who do not currently have healthcare insurance to qualify for Medi-Cal coverage by 2014. As part of that waiver the State of California is implementing mandatory enrollment into Medi-Cal managed care for seniors and persons with disabilities who do not also have Medicare. To improve care coordination, Medi-Cal beneficiaries determined by the State to be persons with disabilities or seniors will be required to join Medi-Cal managed care plans. In San Diego County there are five Medi-Cal managed care plans from which to choose: Care 1st, Community Health Group, Health Net, Kaiser Permanente, and Molina. Representatives from San Diego Regional Center (SDRC) are meeting with representatives from the five participating Health Plans and many other agencies in order to plan for a smooth transition for SDRC consumers who will be mandatory enrollees in managed care health plans. We are working to assure that SDRC consumers will receive the quality health care and benefits that are important to maintain good health. Some Common Questions: Will I be able to select which Health Plan I enroll in? Yes. Will I be able to keep my current doctor? Whenever possible. You will have access to a list of participating doctors and clinics and will be able to select your healthcare provider. When does this change take effect? Beginning June 1, 2011, persons with disabilities or seniors will be required to enroll before or during their birth month. The State of California will mail you more information 60 days in advance. Will I be able to obtain the prescription drugs that I need? Yes, although they must be included in the Health Plans formulary and a covered Medi-Cal benefit. What about behavioral health/mental health benefits? Specialty Mental Health is covered by the County Mental Health Department and not by the Medi-Cal managed care plans. Substance abuse treatment is covered by the Drug Medi-Cal program. There are no current plans for this to change. Will children younger than 19 years of age who have special healthcare needs be required to enroll in a Medi-Cal managed care plan? Care obtained through a special Medi-Cal program (like CCS) will not change. But other healthcare might be through a Medi-Cal managed care plan. Does this change affect people who currently are covered by both Medicare and Medi-Cal? No, unless they are enrolled in a Medicare Advantage plan that also has a Medi-Cal managed care contract. What if I dont do anything? If you do not enroll in a Medi-Cal Health Plan by the end of your birth month, you will be assigned to one, and then your new Medi-Cal Health Plan will send you a membership card. If Im already in a Medi-Cal Health Plan, do I need to do anything? No, you dont need to do anything. Your health care will stay the same. What if I have a problem with Medi-Cal, my Plan or getting the care I need? Call the Help Center: 1-888-466-2219 Call the Medi-Cal Managed Care Ombudsman: 1-888-452-8609 Ask for a Medi-Cal State Hearing: 1-800-952-5253Important Medi-Cal Changes For more information or to enroll in a Medi-Cal Health Plan Call Health Care Options at 1-800-430-4263 or Visit  HYPERLINK "http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspx" http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspx Informacin en Espaol: Cambios Importantes a Medi-Cal Mensaje del director de SDRC Carlos Flores, director ejecutivo Communicator - 2011 primavera California ha recibido del gobierno federal un nuevo formulario de renuncia de Medicaid que se espera permita a ms personas sin seguro mdico calificar para Medi-Cal para el ao 2014. Como parte de este formulario, el Estado de California est implementando la inscripcin obligatoria a Medi-Cal Managed Care (un plan de servicios mdicos coordinados) para personas de la tercera edad o con discapacidades, que adems no tengan Medicare. Para mejorar la coordinacin de los servicios de salud, los beneficiarios de Medi-Cal que el Estado determine sean personas con discapacidades o de la tercera edad tendrn que inscribirse a algn plan de Medi-Cal Managed Care. En el Condado de San Diego hay 5 planes de Medi-Cal Managed Care de dnde escoger: Care 1st, Community Health Group, Health Net, Kaiser Permanente, y Molina. Los representantes del Centro Regional de San Diego (SDRC) se estn reuniendo con representantes de las 5 agencias participantes, y con muchas otras, con objeto de planear una transicin sin contratiempos para los consumidores del SDRC que tendrn que inscribirse obligatoriamente a los planes de servicios coordinados de salud. Estamos trabajando con tesn para asegurarnos que los consumidores del SDRC reciban los servicios de salud y beneficios de calidad que necesitan para mantener la buena salud. Algunas preguntas frecuentes: Podr seleccionar el Plan de Salud al que me inscriba? S. Podr seguir con mi doctor actual? En la medida de lo posible. Usted tendr acceso a una lista de mdicos y clnicas participantes, y de ah podr seleccionar al proveedor de servicios de salud que desee. Cundo entrar en vigor este cambio? A partir del 1o de junio de 2011, las personas con discapacidades y las personas mayores tendrn que suscribirse a ms tardar en su mes de nacimiento. El Estado de California le enviar a usted ms informacin con 60 das de anticipacin. Podr obtener los medicamentos de receta que necesito? S, aunque deben estar incluidos en el formulario del Plan de Salud, y ser un beneficio que cubra Medi-Cal. Y qu hay de los beneficios de salud mental o del comportamiento? Los servicios especializados de salud mental los cubre el Departamento de Salud Mental del Condado, y no los planes de Medi-Cal managed care. El tratamiento para abuso de substancias lo cubre el programa de medicamentos de Medi-Cal. No se preveen cambios en este sentido. Los nios menores de 19 aos con necesidades especiales de servicios de salud tendrn que inscribirse al plan de Medi-Cal Managed Care? Los servicios de salud que se obtienen mediante algn programa especial de Medi-Cal (como el de CCS) no cambiarn. Pero otros servicios se podrn adquirir mediante el plan de Medi-Cal managed care. Este cambio afecta a la gente que actualmente est cubierta tanto por Medicare como por Medi-Cal? No, a menos que estn inscritos en un plan Medicare Advantage que incluya un contrato de Medi-Cal Managed Care. Qu sucede si no hago nada? Si usted no se inscribe a un plan de salud de Medi-Cal a ms tardar el ltimo da de su mes de nacimiento, entonces se le asignar un plan automticamente, y su nuevo plan de servicios de salud de Medi-Cal le enviar a usted una tarjeta de membresa. Si yo ya tengo un plan de servicios de salud de Medi-Cal, necesito hacer algo? No; no es necesario hacer nada. Sus servicios de salud seguiran sin cambiar. Qu puedo hacer si tengo algn problema con Medi-Cal, o con mi Plan, o en lo relativo a los servicios de salud que necesito? Llame al Centro de Ayuda: 1-888-466-2219 Llame al defensor de Medi-Cal Managed Care: 1-888-452-8609 Solicite una audiencia estatal de Medi-Cal: 1-800-952-5253 Para ms informacin, o para inscribirse a algn plan de servicios de salud de Medi-Cal, llame a esta lnea de opciones: 1-800-430-4263. Tambin puede visitar la pgina web del Departamento de Servicios de salud, para mayores informes:  HYPERLINK "http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspx" http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspx ./abmn ' ) @ A y }  46Y!^fPfNOgjy~Ź h5 hhhhh6CJaJh).6CJaJhh).6CJaJh).h5CJaJh5h55mH sH h55mH sH hfG@h55mH sH hM5hh5:/mn( ) @ A y ~  56Y !^ &dPgdgd5gd&fPfO./m &dPgdfG@gdfG@gd~#./abmi;?@Afüod`XSX`X` hfG@5hfG@hfG@5hfG@hfG@hfG@mH sH hfG@hfG@6CJaJmH sH hfG@hfG@5CJaJmH sH hfG@5mH sH hfG@hfG@5mH sH hfG@hfG@hfG@hfG@56 h556 hfG@hhjh:[ZU*hPnh:[Z0J*jh:[ZU h:[Zh:[Zh:[Zjh:[ZU hh ;@Af9)*c& ' x!y!!N"O"m"i#gdfG@9()*c% & ' w!x!y!!M"N"O"m"h#i#j##$ $ $$0%1%2%%& &,&k&m&n&o&&&&&ٺhPnh:[Z0Jjuh:[ZU h:[Zh:[Zh:[Zjh:[ZUhfG@hfG@5mH sH hfG@hfG@hfG@5 hfG@hfG@-i#j## $ $$$$1%2%&&gdfG@ 21h:p/ =!"#$% uDyK @http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspxyK http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspxuDyK @http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspxyK http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspxH@H Normal CJOJQJ_HaJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k@(No ListVOV Default 7$8$H$!B*CJ_HaJmH phsH tH 6U@6  Hyperlink >*B*ph:O: fG@Pa7dB*OJQJph:O: fG@Pa4dB*OJQJph:O: fG@Pa9dB*OJQJph6OA6 fG@A9B*CJOJQJaJph!8OQ8 fG@A7>*B*CJOJQJaJph;% 8  z z z ;/mn()@Ay~56Y !^f P   f   O ./m;@Af9)*c&'xyNOmij  12$$$$G$v:$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$G$v:$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$/mn()@Ay~56Y !^f P   f   O ./m;@Af9)*c&'xyNOmij  120000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000/mn/m200000000000000 )00000000 ܍0000000~&i#&& nXX8@0(  B S  ?!=S=ꪫS>S<몫SLSL=dS<2S,C3S|< SD!SX"SVYS=ZSTlv\SlvaS]SD^S_SĂ`S\STjߪSD^SjફSԃj`Sj᪫STjbSj⪫SԄjdSj㪫STjhSԅj䪫SjSTj媫Sj(p p u [[ttBB      '..t { { ddwwEE     8*urn:schemas-microsoft-com:office:smarttagsCity9*urn:schemas-microsoft-com:office:smarttagsState=*urn:schemas-microsoft-com:office:smarttags PlaceType=!*urn:schemas-microsoft-com:office:smarttags PlaceName9*urn:schemas-microsoft-com:office:smarttagsplace OS!!!!!EIhlY] PTJ N F J V Z 8 <   : > !%,EINRw{|%,-18FHKLRV\lsw  "%*37PWuy&+,5:HLORZ[hpvw|&*/189CHMNRS^_bgs}  %),08;=BGHNlry !+/06;ALQ[^lz} &+018=IMSTWX`cegmnstyz"#15:FKO[_dpw  #,129@DITU_clpuv}~ "$()./8<BCKLT`d&*26:PSTZ[]aepu  %).26>EHMNQRY]fnpqsty7;  7:;FJNOZ]bktx}   tw9;>f+/BE*a Okz|:::::::::::::::::::::::)A / DT1V[U>fnq6m DN^erg)h= !p-/4  oU ~2 ka a ) z 8 xO c',5 (:|IT ? Prd;z)QxgYho;CtJWKdxlD]wZNQ#WZ$jy!Yt 7=i ;jah('62 kj !!!L!T!a!j!6"&c"x$$8$9$[ %d%O%3%8&P'_''+8'b'wp'wq'(6(C(),)T)C*V*d*~* ++Z+R}+ --4-9-B- L-v- .&.@.o.}."/&/1?fG@AA9dABPBB#BSCyCPDaDbDiDItDEFEPE\_ExF\F]FG G/UGmtGR}Gs H &HXH IAI&J8J#\JVK@K0gK#hKpK LLNL2qLRXR$SdTJTVkTwTU>UrUyU#XVpW!WW` X>X/:YkKY {YZHZ:[ZB[\\M,\`\w\]^ _z@_ `.[`j`z`waSb8b8b2Db}8c9c d#kCk4Kkak&l-l3lWly`lEmPmaQm&nnWdn0o o1oSo_ pMp[p>|p8q0r5rHt0t#FtSt2ua3uw8un~uBv[lvvwTwZwmw2vwwxyxOy>y_ydy#zhzQ {-1{A{G{| |M|`|P}q}~>~o~%np7T).]h 45v?@lG%&=|aGfYjS^+=Xp8?&,0E7H8H!N6C3NrTY'f,S4X]%|*{ 0Xe /g4Go7U!H"}Gad#CY rm/=UJs %*I[Vg[g_5FlvU .DqH2DNke EAfST-v.y)3L+P XpOc^ \k8*I,HGQ &,'1=%iN<)~*m;?G1b(rHGj1AmuAhj$};J.3G\ ',:}s5r&(BtG_hxg"*2I>EQMZq2+Kr=HaD%U)I!SLT?Uc<_Oz| $n0u gwTSRVHftmFmSv}f;gdj,BZ_u yuJ/[E]BB.*c%OWFdjWn%x&$i  D|/E{Ign*A(GSX0HIoDXg$ ),6| BNZ-7gB9hnwz-.?X"fy" CMY[mfv3\U - t!8*@%:;OX^btQ/LYu 8Eqevz$9H]| 4'  _ ?L@KtL"BrmyM%@9Xh lpW`}+]*&X3DFPQ)k#[ %-XGaIr7KwT$T1YPwOl-9Y\mhs @'_cv+)(ERSWo@ @S @Unknowngz Times New RomanTimes New Roman5Symbol3& z Arialc Futura XBlk BTFutura XBlk BT"1hz󆳊77!42QHX ? 2.Medi-Cal Update from San Diego Regional Center Sue Moore Sue MooreOh+'0 ,8 X d p|0Medi-Cal Update from San Diego Regional Center Sue MooreNormal Sue Moore4Microsoft Office Word@NZ@\x@!՜.+,D՜.+,\ hp|  7' /Medi-Cal Update from San Diego Regional Center Title 8@ _PID_HLINKSAl io@http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspxio@http://www.dhcs.ca.gov/individuals/Pages/MMCDSPDEnrollment.aspx  !"#$&'()*+,-./0123456789:;<=>?@ABCDEFHIJKLMNPQRSTUVYRoot Entry F#[Data 1Table%vBWordDocument48SummaryInformation(GDocumentSummaryInformation8OCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q