Medi-Cal seen as relief for some, confusing burden for others
The majority of patients who have enrolled in the Affordable Care Act were assigned to Medi-caid. Most feel some ecstasy and relieve that they have health insurance. On Jan. 21, Covered California reported that 584,000 had been "determined likely eligible" for Medi-Cal after visiting CoveredCa.com and an additional 630,000 transitioned into Medi-Cal from separate low-income health programs run by counties. Patients signing on for Medi-Cal join a health plan and receive their care from networks of participating doctors, clinics, hospitals and pharmacies, much like other managed care patients who have private insurance.
There are however many gaps and questions about just what that means. We reported these deficits several months ago. I became aware of these when a member of my family who had been disabled for ten years and had several pre-existing conditions. They did not qualify for SSDI because she had not worked enough in the past 10 years to qualify...largely because she was not able due to her permanent disability.
The Los Angeles Times reports several scenarios that will disappoint those assigned to Medi-caid. Supporters of national healthcare reform tout the expansion of Medicaid — called Medi-Cal in California — as one of the great successes of the Affordable Care Act.
A little-known wrinkle in the decades-old Medicaid law may be prompting some Americans ages 55 to 64 to shy away from the health plan of last resort -- called Medi-Cal in California -- after learning there's a catch: Once they die, their estates may have to reimburse the government for the cost of their medical care. There are significant waivers and exemptions to this law.
MEDICAID ESTATE RECOVERY PROGRAM
From fiscal year 1993-94 to 2013-14, California's Medi-Cal Estate Recovery Program recouped $978.5 million. Of that, 50 percent was returned to the federal government. Over the same period, California's Medi-Cal budget was $621 billion.
California is typically ranked at the top of the list of states in Medicaid estate recovery.
The average estate claim amount in California is $95,000. The average recovery amount is $15,000. This amounts to a paltry amount of less than .000000005 % of the Medi-Cal budget.
Source: California Department of Health Care Services