22-710 Prepare For Your Dual Eligible Patient Transition to a D-SNP and Exclusive Aligned Enrollment Plan
Date: 08/31/22
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
Find out how the Cal MediConnect and D-SNP “Look Alike” member transition might impact you
As of January 1, 2023, members enrolled in a Cal MediConnect (Medicare-Medicaid Plan) or a dual eligible Special Needs Plan (D-SNP) “look alike” will transition to another plan.
What is D-SNP?
Dual Special Needs Plans (D-SNP) are designed to create an integrated approach to care coordination and provide extra support and resources. These plans are for enrollees who have both:
- Medicare and are
- Full dual Medi-Cal
D-SNP Look-Alike member impact
D-SNP Look-Alike plans are Medicare Advantage (MA) plans that are designed specifically to attract dual eligible beneficiaries who have secondary coverage through Medi-Cal.
Per the Centers for Medicare & Medicaid Services (CMS), members enrolled in a
D-SNP “look-alike” must transition to a D-SNP or another MA plan.
Effective January 1, 2023, D-SNP “look-alike” members will be transitioned as follows:
If the member is in: | And they are: | They transition to: |
|---|---|---|
Wellcare Plus Sapphire I (HMO) | Full dual | Wellcare Exclusive Aligned Enrollment (EAE) D-SNP or Unaligned D-SNP as applicable |
Wellcare Plus Sapphire II (HMO) | Partial or non-dual | Non-D-SNP MA plan as applicable |
D-SNP Look-Alike member notification
Members enrolled in the look-alike plans will get either
- An Annual Notice of Change (ANOC) in September which outlines the new plan they will be passively moved to or
- A non-renewal notice in October if they are not being passively moved to another plan. The non-renewal notice provides options for enrollment into other plans for the member
Cal MediConnect member impact
Effective January 1, 2023, Cal MediConnect members will be transition to
- Wellcare by Health Net Exclusive Aligned Enrollment (EAE) D-SNP HMO AND
- Health Net Medi-Cal
Cal MediConnect member notification
Notification | Date |
|---|---|
Member transition guide | September 2022, before the Annual notification of change (ANOC) |
ANOC and other plan materials | Late September 2022 |
Non-renewal notice | October 2022 |
Reminder notice and ID cards | November 2022 |
Outbound phone calls | October and November 2022 |
Watch for additional information
Webinars are scheduled for the months of October, November and December. Be on the lookout for flyers announcing specific dates and times.
Additional information regarding the following topics will be forthcoming during October.
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Don’t forget to visit the D-SNP Resources for Providers page
Visit D-SNP Resources for providers to get detailed information to help support to your staff and patients.
Additional information
If you have questions regarding the information contained in this update, visit D-SNP Resources for providers and refer to the D-SNP FAQ section. For all other questions, contact the applicable Health Net Provider Services Center within 60 days, by email.