Cal MediConnect members may not be able to stay enrolled every year in Health Net's Cal MediConnect Plan.
There are many reasons for this. They include:
- Medicare and Medi-Cal (Medicaid) may not renew their contract with Health Net to offer a Cal MediConnect Plan.
- Health Net may not renew their own contract with Medicare and Medi-Cal (Medicaid) to offer a Cal MediConnect Plan.
- Health Net may need to offer their Cal MediConnect Plan to a smaller service area.
If one of these occurs, you'll be disenrolled from Health Net's Cal MediConnect Plan. Before you're disenrolled, Health Net will send you a letter with information of the change taking place.
The letter will include:
- The date the change will occur.
- Information about your health care coverage choices and the Special Election Period.
Below are your health care coverage options during the Special Election Period:
- Enroll in another Cal MediConnect Plan.
- Enroll in a Medicare Advantage Plan with drug coverage for your Medicare benefits. You must also enroll in a Medi-Cal Managed Care Plan for your Medi-Cal benefits.
- Enroll in Original Medicare and a stand alone Medicare drug plan. You must also enroll in a Medi-Cal Managed Care Plan for your Medi-Cal benefits.
If you don't choose one of these options, you'll be enrolled in Original Medicare and a standalone Medicare drug plan for your Medicare benefits. You'll also be enrolled in Health Net's Medi-Cal Plan for your Medi-Cal benefits. Health Net will continue to cover your health care services until your new health care coverage begins.
When can you end your membership in our plan?
- Because you get assistance from Medi-Cal, you can end your membership in Health Net Cal MediConnect Plan at any time.
- Your membership will usually end on the first day of the month after we receive your request to change plans. Your enrollment in your new plan will also begin on this day.
How to voluntarily end your membership in our plan?
- If you would like to switch from our plan to another Medicare Advantage plan simply enroll in the new Medicare Advantage plan. You will be automatically disenrolled from Health Net Cal MediConnect Plan, when your new plan's coverage begins.
- If you would like to switch from our plan to Original Medicare but you have not selected a separate Medicare prescription drug plan. You must ask to be disenrolled from Health Net Cal MediConnect Plan. There are two ways you can asked to be disenrolled:
- To disenroll, please call Health Care Options (HCO) at 1-844-580-7272, 8am - 6pm (PST), Monday - Friday except holidays. TTY/TDD users should call 1-800-430-7077. For more information visit the DHCS website*.
- Or you can contact Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
Until your membership ends, you are still a member of our plan.
If you leave Health Net Cal MediConnect Plan, it may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care and prescription drugs through our plan.
- You should continue to use our network pharmacies to get your prescriptions filled until your membership in our plan ends. Usually, your prescription drugs are only covered if they are filled at a network pharmacy including through our mail-order pharmacy services.
- If you are hospitalized on the day that your membership ends, you will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins).
*By clicking on these links you will be navigating away from Health Net Cal MediConnect's website.