Medical Coverage Gap Prevention

Medical Coverage Gap Prevention

By: Tom Lau, Eligibility Review Unit

Medical Coverage Gap Prevention

Medical Coverage Gap Prevention 1024 683 My Health LA

Community Partners are asked to ensure MHLA participants’ access to medical care will never be disrupted. Active outreach with telephone, text, and letter reminders will help eliminate these two foreseeable gaps in coverage before they occur.

50+ eligibility to full-scope Medi-Cal

As of May 1, 2022, all MHLA participants aged 50 and over will be eligible for full-scope Medi-Cal, ending their eligibility for MHLA. Those already enrolled in restricted-scope Medi-Cal will automatically transition to full-scope Medi-Cal. Members should be educated on this new rule and be encouraged to apply for restricted-scope Medi-Cal before turning 50 to prevent any gaps in coverage.

Annual Renewals

Participants should be reminded to complete their renewal for continued enrollment in MHLA. Renewals can not only be done in person but over the telephone, using the TERF (Telephone Enrollment/Renewal Form) here.

Member Contact List

Participant’s contact information can be downloaded from One-e-App. This contact list (called the Medical Home Summary) will show a CP’s currently active members with their addresses and telephone numbers.

Active Member Lookup Tool

For agencies with a large list of active members, the Active Member Lookup Tool can be used to filter this contact list by age and upcoming renewal due dates so they can narrow their focus on who to contact.  Instructions on downloading the Medical Home Summary and using the Active Member Tool can found on the MHLA website under Medi-Cal Expansion to 50+ /Active Member Lookup Tool.