22-217m Expect More Patients from Medi-Cals Older Adult Expansion
Date: 03/30/22
This information applies to Physicians and Participating Physician Groups (PPGs).
New patients may arrive beginning May 2022
As of May 1, 2022, California state Assembly Bill (AB) 133 provides full-scope Medi-Cal coverage to adults ages 50 or older, regardless of immigration status. All other Medi-Cal eligibility rules, including income limits, will still apply.1
The initiative is called the “Older Adult Expansion” (OAE). It is modeled after the Young Adult Expansion, which provided full-scope Medi-Cal to young adults ages 19–25, inclusive.1
Enrollment and member notices
The OAE population will go through the same plan choice process as the rest of the Medi-Cal population. Those eligible for OAE can enroll into a managed care plan as early as May 1, 2022, and default into a plan by July 1, 2022.1
The OAE population will receive the notices shown in the chart below.
Topic and sender | When |
1st notice and FAQs from the California Department of Health Care Services (DHCS) | March 7–13, 2022 (completed) |
2nd notice and choice packet from the county | 2nd notice: April 8–12, 2022 Choice packet: April 11, 2022–TBD |
Enrollment notice from DHCS | April 18–29, 2022 |
Watch for DHCS updates
DHCS will post a provider bulletin on the Medi-Cal provider website approximately 45 days prior to the transition date. The bulletin will remind providers of the implementation of the OAE and include contact information for provider questions.1
Additional information
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
1Information adapted or taken from DHCS website at www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx and All County Welfare Director’s Letter 21-13.