Health Care for Immigrants. Training conducted by: Liz Ramirez, Director of Training Maternal Child Health Access
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1 Health Care for Immigrants Training conducted by: Liz Ramirez, Director of Training Maternal Child Health Access (213)
2 Overview of the following: MEDI-CAL IMMIGRATION CATEGORIES PRUCOL OTHER MEDI-CAL PROGRAMS KAISER CHILD HEALTH PROGRAM MY HEALTH LA & OTHER COUNTY PROGRAMS
3 Medi-Cal
4 AS OF TODAY I INTEND TO STAY! CALIFORNIA RESIDENCY
5 Medi-Cal Immigration Basics Who gets what?
6 WHAT IS MY STATUS? U.S CITIZEN LEGAL PERMANENT RESIDENT UN-DOCUMENTED LAWFULLY PRESENT DACA
7 UNDOCUMENTED A foreign-born person who lacks a right to be in the United States, having either entered without inspection (and not subsequently obtained any right to remain) or stayed beyond the expiration date of a visa or other status RESTRICTED SCOPE MEDI-CAL
8 Restricted medi-cal cover What does it cover? Emergencies What s an emergency? Pregnancy Dialysis Long Term Care
9 0-138% FPL % FPL US Citizen and Qualified Immigrants Undocumented Full Scope Medi-Cal Pregnancy** Medi-Cal No Managed Care Pregnancy** Medi-Cal No Managed Care Pregnancy** Medi-Cal No Managed Care **Pregnancy Medi-Cal now covers EVERYTHING that is medically necessary!!!!!
10 Medi-Cal Access Program Formerly Access for Infants and Mothers (AIM) Income % poverty, or $500 maternity deductable (insurance cost) Has been programmed into CalHEERS Family Size MAGI Monthly Family Income Total Cost Payments of: (1.5% of your MAGI Monthly Income x 12 ) 12 Monthly *2 $2,806 - $4,221 $505 - $760 $42- $64 3 $3,530 - $5,311 $530- $796 $45 - $67 4 $4,254 - $6,400 $639 - $960 $54 - $80
11 Medi-Cal Access Program Is now -ALMOST- Medi-Cal MCAP provider system is now in Fee For Service Medi-Cal Will move to Managed Care in June, 2017 Full coverage, including dental Eligibility goes back to first of the month of application Other changes: 1) Pregnant applicants in Covered CA with income between % are offered the option of enrolling in MCAP 1) If income drops during pregnancy can now switch to free Medi-Cal with no penalty
12 UNDOCUMENTED CHILDREN 0-19 PRUCOL U.S CITIZEN QUALIFIED IMMMIGRANT FULL SCOPE MEDI-CAL DACA
13 Qualified Immigrants Medi-Cal uses this term to define immigrants who are eligible for full scope benefits. They include: Legal Permanent Residents LPR - NO 5 YEAR BAR IN CA Asylees Refugees Cuban & Haitian Entrants Certain battered spouses and victims of trafficking (U & T visa holders) Individuals Paroled into the U.S. for at least 1 year And PRUCOL categories
14 Permanently Residing in the U.S. Under Color Of Law P R U C O L Undocumented immigrants who would otherwise only be eligible for restricted scope benefits can get full-scope benefits if they are in the process of adjusting their immigration status. PRUCOL will only determine the scope of benefits. The family or individual still has to meet the income requirements. PRUCOL is not an immigration term; it is a public benefits eligibility category through which certain undocumented immigrants can apply for Medi-CAL
15 DACA & TPS Temporary Protective Status TPS Deferred Action for Childhood Arrivals DACA
16 NON- IMMIGRANT STATUS Lawfully Present Student Visas F1 F2 Investor Visas E1 NOT ELIGIBLE FOR MEDI-CAL Religious Workers R1 Diplomats C3 Visitors B1 Specialty Employment Visas H1 - H1 B ELIGIBLE FOR MARKETPLACE COVERAGE
17 IMMIGRATION STATUS & THE MAREKTPLACE TAKE NOTE NON- IMMIGRANT STATUS who are lawfully present are not eligible for Medi-CAL. Worker Visas (such as H1, H-2A, H-2B) Student Visas Investors Religious Workers People with D.A.C.A. status are NOT eligible to purchase insurance through Covered CA. Individuals who are lawfully present, but are ineligible for Medi-CAL based on immigration status, qualify to receive subsidies on Covered CA even if their income is under 138% FPL.
18 OTHER MEDI-CAL PROGRAMS
19 Breast and Cervical Cancer Treatment Program Federal Program 200% FPL Women Under 65 Satisfactory Immigration No other coverage Full scope Medi-Cal State Program 200% FPL Women of any age or Man with breast cancer Undocumented, Citizen or National Treatment of Breast or Cervical Cancer Time limit of coverage but can be renewed To find a BCCTP Provider call:
20 MINOR CONSENT Medi-Cal Minors between the ages of 12 and 21. There are no immigration or income requirements. Services are limited to: Pregnancy Care Abortion Contraception Sexual assault and STD treatment Mental Health services Drug and Alcohol treatment Apply with Department of Public Social Services
21 Kaiser Child Health Program KPCHP is still open for kids with family income 267%-300% FPL. Kaiser Permanente Platinum 90 HMO Dental coverage Delta Care No-copayments Closed for enrollment Unless client qualifies for Special enrollment Open enrollment begins November 1,
22 LA COUNTY Health Programs OK, What about the rest of us?
23 MY HEALTH LA At or below 138% FPL Cannot be eligible for Full Scope Medi-Cal Patients choose a medical home Specialty Care and Hospitalizations are referred to the LA County Department of Health Services
24 L.A. COUNTY DEPARTMENT OF ABILITY TO PAY (ATP) HEALTH SERVICES LA County residents who do not qualify for Medi-Cal or Medicare Clinic and outpatient hospital visits Includes Specialty Care Tests and medicines Inpatient hospital care Emergency Room visits Certain surgeries
25 County Pre-Pay Program $60 for clinic visits at Comprehensive Health Centers (CHC) and Health Centers (HC); $80 for clinic visits at county hospital clinics and Multiservice Ambulatory Care Centers (MACC); $80 for urgent care visits at all County facilities; $140 at county hospital emergency rooms; $500 at outpatient surgery clinics. $2000 Pre-Natal and Child Delivery Plan (mother must apply for Medi-Cal for newborn).
26 Programs with a California Children Services (CCS) is a Statewide program that treats children under 21 with certain physically disabling conditions. Cancer Detection Program: Every Women Counts provides breast and cervical cancer screening and diagnostic services. Family Planning Access, Care and Treatment is a state funded program to provide comprehensive family planning services including treatment for a sexually transmitted disease.
27 CONTACT US! (213) New MCHA pregnancy coverage helpline:
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