DHCS Allows Brokers to Market Cal MediConnect Plans

Despite strong opposition from California Health Advocates and other advocates statewide, California’s Department of Heath Care Services (DHCS) recently approved a new pilot that will allow brokers to market Cal MediConnect plans to dual eligibles as of January 1, 2019. This new pilot overturns a longtime ban on brokers which prevented them from marketing Cal Mediconnect plans for fear of exposing consumers to potentially harmful broker misconduct and disruptions in care. While DHCS has noted that existing marketing guidelines from the Centers for Medicare and Medicaid Services will apply, how that will play out specifically is not yet known. This new policy to introduce brokers is inconsistent with consumer experience on the ground. Read more.

Special Election Period Changes for Dual Eligibles & Others with Extra Help, Starting January 2019

Currently people who have both Medicare and full Medi-Cal coverage and others with the Extra Help for Part D are allowed to change their Medicare Advantage (MA) and/or Part D prescription drug plan (PDP) during any month of the year. They have what’s called a continuous special election period (SEP). As of January 1, 2019, however, these beneficiaries will lose this continuous SEP and only be able to switch plans once a quarter for the first three quarters of the year, and then once during Medicare’s annual open enrollment period. Read more.

Beware of Agent Misconduct ~ Know Medicare's Marketing Rules

With Medicare’s fall open enrollment period just a couple months away (Oct 15 – Dec 7), it’s good to remind ourselves of Medicare’s marketing rules. Knowing the “do’s and don’ts” that all insurance agents and brokers must follow, helps to detect and prevent fraud. This article provides simple reminders, updates on some changed rules for 2019, and resources for outreach and education. Read more.

Administration Imposes Deep Cuts to Grants Helping Americans Buy ACA Plans...Again

In July, the Trump Administration took more actions towards sabotaging the Affordable Care Act (ACA) and people’s access to quality health care suitable for their needs. The Administration is eliminating almost all the funding for “navigators”, the grass roots groups that help Americans “navigate” the health insurance marketplace to buy coverage, and, at the same time, is asking navigators to promote “junk plans” that bypass the consumer protections and benefit requirements of ACA plans. Read more.

CHA Opposes SB 1004 ~ Save Funding for Older Adults' Mental Health Services

The California Collaborative for Long Term Care Services of which California Health Advocates is a member, submitted this letter opposing SB 1004. This bill would limit access to Mental Health Services Act Prevention and Early Intervention (PEI) services for older adults by establishing new priorities for PEI funding that instead emphasize children and youth. Yet there is overwhelming evidence, some of which is cited in the letter, that older adults need mental health prevention and early intervention services. Read more.

Introduced Bill Would Strengthen Medigaps & Consumer Protections

Last month, Representative Sandy Levin (D-MI), Ranking Member of the Ways and Means Health Subcommittee, introduced the Medigap Consumer Protection Act of 2018. This legislation would provide a long overdue overhaul on Medigap’s consumer protections, ensuring all beneficiaries, regardless of their age, disability, or any other pre-existing condition, have ease in accessing information on these plan options and in purchasing them. Read more.

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