Beneficiaries


About the Coordinated Care Initiative


If you pay for your health care services using both Medicare and Medi-Cal, you have new choices to make about your health care coverage. In 2014, the Department of Health Care Services (DHCS) began a program called the Coordinated Care Initiative (CCI), which is designed to provide participants with better health care service.

The federal Medicare program and the state Medi-Cal program have partnered to start a new project to improve care for California’s seniors and people with disabilities who are dually eligible for both of the public health insurance programs, “dual eligible beneficiaries” (also known as “dual eligibles,” Medi-Medi beneficiaries” or “Medi-Medis”.) This project, the Coordinated Care Initiative (CCI), will take place in seven counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara. If you’re a dually eligible beneficiary, this means changes for the way your health care operates. The CCI has two parts:


Cal MediConnect: 

All of a beneficiary’s medical, behavioral health, long-term institutional, and home- and community-based services will be combined into a single health plan. This will allow your providers to better coordinate your care and make it simpler for you to get the right care at the right time in the right place.


Medi-Cal Managed Long Term Supports and Services (MLTSS): Medi-Cal beneficiaries, including dual eligible beneficiaries who have opted out of Cal MediConnect or who are not eligible for Cal MediConnect, are required to join a Medi-Cal managed care health plan to receive their Medi-Cal benefits, including long-term supports and services (LTSS) and Medicare wrap-around benefits.


California’s Coordinated Care Initiative – Cal MediConnect

The Cal MediConnect program aims to improve care coordination for dual eligible beneficiaries and drive high quality care that helps people stay healthy and in their homes for as long as possible. Additionally, shifting services out of institutional settings and into the home and community helps create a person-centered health care system that is also sustainable.

Medi-Medi Plans


Individuals who are over 65 and are also disabled may qualify for both Medicare and Medi-Cal benefits. These individuals are known as “dual eligibles” or “Medi-Medis.”

Coverage includes doctor and dental services, clinic and hospital services, nursing home and home health care, mental health care and some prescription drugs.

Depending on the county you live in, California’s Medi-Medis program has a variety of benefits for California’s seniors that may include covering your co-pays and paying your Part A and B premiums.

Some Medi-Medis may also qualify for California’s Medi-Connect program available in the counties of Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara. Medi-Connect is a managed health plan where all of your healthcare costs, including hospital, doctor visits, prescription drug, long term care and in home health care will be provided by one plan.

California’s Medicare and Medi-CAL programs provide great benefits for California’s seniors but are complex.

Call us at 877-344-1744 to learn more about Medi-Medi plans in your county:

​Los Angeles

Riverside

San Diego

San Meteo

San Bernardino

Santa Clara

Orange 

 Alameda