When Lloyd Tennison moved from Walnut Creek to Stockton last year, he assumed his coverage under Medi-Cal, California’s safety-net health insurance program, would be transferred seamlessly.
About three weeks before his May move, Tennison called the agency that administers Medi-Cal in Contra Costa County, where Walnut Creek is located, to inform them he’d be moving to San Joaquin County.
He had no idea that his transfer to Stockton would be tangled up in red tape and disrupt his health care. Two bills totaling $1,700 were incurred after he was dropped from his previous plan without prior notice.
Medi-Cal members who move counties are often bumped temporarily from managed care insurance plans into traditional Medi-Cal, also known as “fee for service,” in which the state pays providers directly for each service rendered. But managed care practitioners who don’t participate in traditional Medi-Cal have no way to get paid when they see such patients, and they sometimes bill them directly — even though that’s prohibited.
Medi-Cal may be a statewide health care program, but its administration is handled by counties. These counties have different government bureaucracies, and they also use different methods of providing healthcare :…