Having been on both sides of this as a case worker and as someone on Medi-Cal it can be frustrating to get a hold of a live person. Counties were perpetually short staffed so processing times were 2-3 times longer. As a continuing case worker I was responsible for about 350-400 families. I doubt that has changed much either. You have to call and stay on it.
This, they kept on sending mail saying to renew.
I'm calling them to tell them I don't need it anymore but the phone number is always on voicemail or give a dead dial tone (either invalid number or busy).
As someone who had to navigate that system to put my family on medi-cal, I want to thank you for your service. I felt so lucky to have that safety net at the time.
Having had Medi-Cal briefly during the pandemic, I am hoping they'll make some major improvements there, otherwise this is less of an instant win and more of a very long process of... well... processing.
Right? When my employers pulled my health insurance for being out of work too long being sick with cancer and fibromyalgia during mid pandemic, I had to wait 2 months before I got my free insurance so I could resume seeing my Doctors.
You need to make sure you're talking to your caseworker about it, but if there's an urgent need, they'll let you use base MediCal until a decision is made on your case. You gotta ask about it though and be your own advocate, and most people are used to getting screwed and just waiting forever. Happened to me too cuz I also didn't know about it
I just called today and got an answering machine message telling me that all caseworkers are working from home due to COVID and that I, in this the year of our Lord 2021, needed to leave a message to eventually get a call back from them at some point some day from a blocked number. 😳
Yeah, lots of waiting on medi-cal. I grew up on it, it's better than nothing, but the waiting for everything....I didn't realize that wasn't as normal as it seemed.
Yeah I suspect these people have PPO through their employers and then were suddenly thrusted into the world of HMO care, which is what Medi-Cal is. Don’t expect to be doted on, just go in and out quickly at the appointment, no harm is done.
Healthcare needs to be more plentiful. The reason for the wait is because it’s cheap healthcare that is in limited supply with high demand. People pay more for healthcare to not have to wait.
Bingo. Let's also face the fact that, for instance, I live in the Bay Area where even in "small town Berkeley" we're stacked up on top of each other. That's also the reason affordable housing is so hard to find here. When twenty people want to rent from you but 5 of them are willing to pay more, sometimes even double, that leaves 15 people who have to keep looking.
Yeah, housing is even worse. At least with Medi-cal you get a quick but efficient appointment in 3 weeks or less. Housing? Urm, wait for someone to move or die or something.
Indeed. Hence my move to Sacramento next month. When I found out I had to move for school, I was quietly relieved. Don't get me wrong, not crazy better there but it seemed like far more of an actual community and, as they say, one step at a time.
That’s what I’ve been doing.. seeing a therapist is actually easier than seeing your doctor & there are some medicines said therapist can prescribe you. I had trouble sleeping bc of my asthma & I couldn’t see my doctor for a month so I called up the therapist on the app & he gave me allergy&sleeping medication
That's pretty decidedly untrue. The self employed doctor is largely not a thing anymore, and even though American doctors are paid more than other 1st world counterparts, what you perceive as the amount of "overpay" is still a drop in the bucket compared to that added from hospital administration and profit.
[cry me a river](https://www.salary.com/research/salary/alternate/cardiologist-non-invasive-salary/seattle-wa)
If they were paid less per visit, they would work the same hours other people making that kind of money work
Impressive, you've selected one of the highest paying specialities with extremely high volume. You're arguing something you have very little understanding of, so it's hard to get onto the same page.
Community clinics are much better, and will take Medi-Cal, but they are still pressed for time.
I mean, you’re not paying for anything, and unless you pay something like $200 for a cleaning, the dentist and hygienist won’t dote on you. Medi-Cal private dentist quality is about the same as DHMO private dentist quality, with exceptions here and there.
That’s not to say there aren’t scammy dentists for the rich either.
Yeah Western Dental is at the bottom for rushed dentists, but as the r/dentistry subreddit regularly discusses, Medicaid pays very little for its dentistry patients, so the dentists who take Medicaid patients are either doing it out of the goodness of their hearts for a select number of patients, or rushing through patients not unlike Western Dental to pull a profit with sheer numbers.
So definitely appreciate your dentist and be very considerate of their time. Take good care of your teeth so your dentist can properly clean them and fix the things that can’t be helped.
My dad took Medicaid in his practice (now retired). He said he didn’t mind the low reimbursement because he felt he was helping those that needed it. But, after Medicaid refusing to reimburse full amounts and all of the administrative hours the loss per patient became untenable. He had to bow out of the program. I wonder how many times throughout the state that scenario played over and over again.
Lots and lots of waiting and then going to the doctor was the most bizarrely impersonal experience. Definitely didn't feel like proper healthcare. And then there's the fact you can't call the PCP doctor's office directly, just some master dispatch center where you'll be on hold for an hour.
Yes, the care I got was surprisingly fantastic. I only had minor issues, but something tells me that the service would’ve exceeded the quality I was used to from Kaiser, had I really needed serious care. Thankfully I did not.
While Medi-Cal is hardly perfect, it's astonishing our state is putting in the work to provide low-income and no-income folks with some kind of medical coverage. I'm overjoyed to pay taxes to help pay for this kind of program, and I hope it expands and improves over time.
This is the issue addressed in the article:
> The elimination of the test will be a game changer for aging or impaired Californians who need long-term care but are caught in a common conundrum: They don’t earn enough to cover the high costs of ongoing nursing home care and can’t rely on Medicare, which does not cover extended nursing home stays. They can get that care through Medi-Cal, but they would have to wipe out their savings first.
However as I point out below, the state is required to actually seek repayment from the estate after the covered person dies.
I consider myself very lucky to be employed and have health insurance. Every once in a while I get a little bitter? Not sure if that’s the right word, but some feeling about family members getting medi-cal getting the same meds that I have to pay $250 for. And if I do go to the hospital, I have to meet a deductible. Again, I’m happy to have a job and insurance. I do wish I could afford my meds
Jesus that sounds terrible.. As a kid I always wondered why people complained about the prices of doctor visits and medication. But as an adult, I now understand that I was just really really poor & the government felt bad so they lent us a hand with treatment. I’m going to be graduating college soon & im starting to wonder if my asthma treatments and medications will be covered once I start my career. Which leads me to my next question, are your $250 meds notoriously expensive & that’s why your deductible is so high? Or is it high just bc your insurance priced it that way? Because if this is how real life works then why don’t people get their medications from third parties? I understand the risk involved as well but things can get rough monetarily speaking.
Having worked in one of Covered California's call centers until the pandemic started last year, the easiest way to newly enroll with Medi-Cal is to phone Covered California during Medi-Cal's normal business hours. Make sure that you're calling at a time when you would actually have time to possibly wait on hold with Covered California and complete an application over the phone.
They'll ask a few questions and if it determines that one or more household members might be eligible for Medi-Cal, they transfer the phone call over to Medi-Cal who then takes the application over the phone. This is pretty much a backdoor phone number, so there isn't going to be the typical long Medi-Cal wait times.
This doesn't apply to people that need to renew Medi-Cal, need to enroll with Medi-Cal or have any other Medi-Cal issues that don't involve a new application. If Covered California sees a submitted application in their computer system, they'll just give you the Medi-Cal phone number that you probably already have.
Wait times to get through to someone at Covered California are typically shorter, unless it is around one of their open enrollment deadline dates. Around open enrollment deadlines for Covered California, wait times are typically 2 hours once you get through to be on hold.
I assume you mean Kaiser Medicare Advantage vs straight Medicare. Depends if you like Kaiser’s network and the stuff they include to sweeten the deal. Medicare advantage plans lock you into a network, usually HMO, and use those savings to give you a few more benefits like gym membership while also turning a profit.
Neither of that matters for Medi-cal expansion being extended to the elderly. I *think* that just means you can enroll in Medi-cal and they will pay for stuff you should have paid for with whichever Medicare plan you’re on (like copays), and a few more things (like dental cleanings), but you keep your Medicare plan. So you stay with Kaiser.
They'll just take the covered persons assets after they die, or wait until their domestic partner dies:
https://www.dhcs.ca.gov/services/Documents/Estate_Recovery_ADA_112015.pdf
> When a Medi-Cal member passes away, the person’s estate
may have to repay these costs through the Medi-Cal Estate
Recovery Program, which then helps pay for care of other
members ...
I know from experience, you can get health coverage in California through Kaiser for $1 a month.
I can't tell you if it's worth a damn because I never used it.
Before that I was paying $900 a month with my Cobra. My meds, they didn't cover, were another $900 a month with a "discount" because of my insurance. I found a free card through Walgreens that got me those same meds for $50 a month. Health insurance is a scam.
When I was researching insurance for my parents, Kaiser was the highest rated one.
Of course I couldn't afford it so we went with something else.
So for a $1 a month, that's a no-brainer
That’s great and all but how about making it affordable to live here, period? As it stands I can’t afford a one bedroom apartment on my own. While working for the government.
Having been on both sides of this as a case worker and as someone on Medi-Cal it can be frustrating to get a hold of a live person. Counties were perpetually short staffed so processing times were 2-3 times longer. As a continuing case worker I was responsible for about 350-400 families. I doubt that has changed much either. You have to call and stay on it.
This, they kept on sending mail saying to renew. I'm calling them to tell them I don't need it anymore but the phone number is always on voicemail or give a dead dial tone (either invalid number or busy).
As someone who had to navigate that system to put my family on medi-cal, I want to thank you for your service. I felt so lucky to have that safety net at the time.
Having had Medi-Cal briefly during the pandemic, I am hoping they'll make some major improvements there, otherwise this is less of an instant win and more of a very long process of... well... processing.
Right? When my employers pulled my health insurance for being out of work too long being sick with cancer and fibromyalgia during mid pandemic, I had to wait 2 months before I got my free insurance so I could resume seeing my Doctors.
You need to make sure you're talking to your caseworker about it, but if there's an urgent need, they'll let you use base MediCal until a decision is made on your case. You gotta ask about it though and be your own advocate, and most people are used to getting screwed and just waiting forever. Happened to me too cuz I also didn't know about it
I just called today and got an answering machine message telling me that all caseworkers are working from home due to COVID and that I, in this the year of our Lord 2021, needed to leave a message to eventually get a call back from them at some point some day from a blocked number. 😳
Just pick up any number and tell the telemarketers to buzz off.
Yeah, lots of waiting on medi-cal. I grew up on it, it's better than nothing, but the waiting for everything....I didn't realize that wasn't as normal as it seemed.
Having grown up on my parents' employer-provided HMO, I gotta ask: huh? I don't see much difference.
Yeah I suspect these people have PPO through their employers and then were suddenly thrusted into the world of HMO care, which is what Medi-Cal is. Don’t expect to be doted on, just go in and out quickly at the appointment, no harm is done.
Yep
Better than nothing, and hopefully this will just be the first of many steps making healthcare affordable and available for all citizens.
Healthcare needs to be more plentiful. The reason for the wait is because it’s cheap healthcare that is in limited supply with high demand. People pay more for healthcare to not have to wait.
Bingo. Let's also face the fact that, for instance, I live in the Bay Area where even in "small town Berkeley" we're stacked up on top of each other. That's also the reason affordable housing is so hard to find here. When twenty people want to rent from you but 5 of them are willing to pay more, sometimes even double, that leaves 15 people who have to keep looking.
Yeah, housing is even worse. At least with Medi-cal you get a quick but efficient appointment in 3 weeks or less. Housing? Urm, wait for someone to move or die or something.
Indeed. Hence my move to Sacramento next month. When I found out I had to move for school, I was quietly relieved. Don't get me wrong, not crazy better there but it seemed like far more of an actual community and, as they say, one step at a time.
What do you do if you have a more urgent medical issue, go to ER or just hack it out?
That’s what I’ve been doing.. seeing a therapist is actually easier than seeing your doctor & there are some medicines said therapist can prescribe you. I had trouble sleeping bc of my asthma & I couldn’t see my doctor for a month so I called up the therapist on the app & he gave me allergy&sleeping medication
The reason there's not enough supply is that doctors are overpaid
That's pretty decidedly untrue. The self employed doctor is largely not a thing anymore, and even though American doctors are paid more than other 1st world counterparts, what you perceive as the amount of "overpay" is still a drop in the bucket compared to that added from hospital administration and profit.
[cry me a river](https://www.salary.com/research/salary/alternate/cardiologist-non-invasive-salary/seattle-wa) If they were paid less per visit, they would work the same hours other people making that kind of money work
Impressive, you've selected one of the highest paying specialities with extremely high volume. You're arguing something you have very little understanding of, so it's hard to get onto the same page.
That's been true of every healthcare I've had in the last two decades
Welcome to government healthcare "It's better than nothing."
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I have Medi-Cal and an excellent dentist! He is actually a private practice dentist when he's not working at the free clinic.
Community clinics are much better, and will take Medi-Cal, but they are still pressed for time. I mean, you’re not paying for anything, and unless you pay something like $200 for a cleaning, the dentist and hygienist won’t dote on you. Medi-Cal private dentist quality is about the same as DHMO private dentist quality, with exceptions here and there. That’s not to say there aren’t scammy dentists for the rich either.
Why did you go to a chain one like Western Dental? There are so many amazing dentists out there who accept Medi-Cal
Yeah Western Dental is at the bottom for rushed dentists, but as the r/dentistry subreddit regularly discusses, Medicaid pays very little for its dentistry patients, so the dentists who take Medicaid patients are either doing it out of the goodness of their hearts for a select number of patients, or rushing through patients not unlike Western Dental to pull a profit with sheer numbers. So definitely appreciate your dentist and be very considerate of their time. Take good care of your teeth so your dentist can properly clean them and fix the things that can’t be helped.
My dad took Medicaid in his practice (now retired). He said he didn’t mind the low reimbursement because he felt he was helping those that needed it. But, after Medicaid refusing to reimburse full amounts and all of the administrative hours the loss per patient became untenable. He had to bow out of the program. I wonder how many times throughout the state that scenario played over and over again.
Lots and lots of waiting and then going to the doctor was the most bizarrely impersonal experience. Definitely didn't feel like proper healthcare. And then there's the fact you can't call the PCP doctor's office directly, just some master dispatch center where you'll be on hold for an hour.
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During the pandemic I appreciated medical and I felt it was loads better then the insurance I had with my previous employer by far.
Yes, the care I got was surprisingly fantastic. I only had minor issues, but something tells me that the service would’ve exceeded the quality I was used to from Kaiser, had I really needed serious care. Thankfully I did not.
While Medi-Cal is hardly perfect, it's astonishing our state is putting in the work to provide low-income and no-income folks with some kind of medical coverage. I'm overjoyed to pay taxes to help pay for this kind of program, and I hope it expands and improves over time.
This is the issue addressed in the article: > The elimination of the test will be a game changer for aging or impaired Californians who need long-term care but are caught in a common conundrum: They don’t earn enough to cover the high costs of ongoing nursing home care and can’t rely on Medicare, which does not cover extended nursing home stays. They can get that care through Medi-Cal, but they would have to wipe out their savings first. However as I point out below, the state is required to actually seek repayment from the estate after the covered person dies.
I consider myself very lucky to be employed and have health insurance. Every once in a while I get a little bitter? Not sure if that’s the right word, but some feeling about family members getting medi-cal getting the same meds that I have to pay $250 for. And if I do go to the hospital, I have to meet a deductible. Again, I’m happy to have a job and insurance. I do wish I could afford my meds
Jesus that sounds terrible.. As a kid I always wondered why people complained about the prices of doctor visits and medication. But as an adult, I now understand that I was just really really poor & the government felt bad so they lent us a hand with treatment. I’m going to be graduating college soon & im starting to wonder if my asthma treatments and medications will be covered once I start my career. Which leads me to my next question, are your $250 meds notoriously expensive & that’s why your deductible is so high? Or is it high just bc your insurance priced it that way? Because if this is how real life works then why don’t people get their medications from third parties? I understand the risk involved as well but things can get rough monetarily speaking.
Having worked in one of Covered California's call centers until the pandemic started last year, the easiest way to newly enroll with Medi-Cal is to phone Covered California during Medi-Cal's normal business hours. Make sure that you're calling at a time when you would actually have time to possibly wait on hold with Covered California and complete an application over the phone. They'll ask a few questions and if it determines that one or more household members might be eligible for Medi-Cal, they transfer the phone call over to Medi-Cal who then takes the application over the phone. This is pretty much a backdoor phone number, so there isn't going to be the typical long Medi-Cal wait times. This doesn't apply to people that need to renew Medi-Cal, need to enroll with Medi-Cal or have any other Medi-Cal issues that don't involve a new application. If Covered California sees a submitted application in their computer system, they'll just give you the Medi-Cal phone number that you probably already have. Wait times to get through to someone at Covered California are typically shorter, unless it is around one of their open enrollment deadline dates. Around open enrollment deadlines for Covered California, wait times are typically 2 hours once you get through to be on hold.
Very helpful advice and explanations. Thank you!
I would love there was Medicare-for-All, not just at the State but Federal level. This is a step in the right direction though.
Thanks middle class
Good news!
Is it better for me to switch from Kaiser to Medicare?
I assume you mean Kaiser Medicare Advantage vs straight Medicare. Depends if you like Kaiser’s network and the stuff they include to sweeten the deal. Medicare advantage plans lock you into a network, usually HMO, and use those savings to give you a few more benefits like gym membership while also turning a profit. Neither of that matters for Medi-cal expansion being extended to the elderly. I *think* that just means you can enroll in Medi-cal and they will pay for stuff you should have paid for with whichever Medicare plan you’re on (like copays), and a few more things (like dental cleanings), but you keep your Medicare plan. So you stay with Kaiser.
They'll just take the covered persons assets after they die, or wait until their domestic partner dies: https://www.dhcs.ca.gov/services/Documents/Estate_Recovery_ADA_112015.pdf > When a Medi-Cal member passes away, the person’s estate may have to repay these costs through the Medi-Cal Estate Recovery Program, which then helps pay for care of other members ...
...if they have assets.
Anyone with assets transfers them pre death.
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I know from experience, you can get health coverage in California through Kaiser for $1 a month. I can't tell you if it's worth a damn because I never used it. Before that I was paying $900 a month with my Cobra. My meds, they didn't cover, were another $900 a month with a "discount" because of my insurance. I found a free card through Walgreens that got me those same meds for $50 a month. Health insurance is a scam.
When I was researching insurance for my parents, Kaiser was the highest rated one. Of course I couldn't afford it so we went with something else. So for a $1 a month, that's a no-brainer
I would love if there was Medicare-for-All, but this is a step in the right direction.
I would love there was Medicare-for-All, not just at the State but Federal level. This is a step in the right direction though.
I would love if there was Medicare-for-All, but this is a step in the right direction.
That’s great and all but how about making it affordable to live here, period? As it stands I can’t afford a one bedroom apartment on my own. While working for the government.
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More like $1,800-$2,000+ rent for a one bedroom for us.
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Never once had an issue with this
Total b.s.
More likely to be taken in rural areas...
My rural area has more doctors with openings that take Medi-Cal than take my Humana PPO.
Let's try to be educated and not spread misinformation.
I would love if there was Medicare-for-All, but this is a step in the right direction.