This story originally appeared on California Health Report and was produced in collaboration with News for Chinese, which published a Chinese version.
Kelly Ko from Freemont stared at the stack of papers. She had come by post, from the local government, in a large envelope. Inside it was a winding 19-page form requesting her family’s exact income, tax filing status, expenses and deductions, and details about her existing health insurance. She didn’t know how to answer all the questions.
And her son’s well-being depended on her filling it out correctly.
Ko’s 17-year-old son Darren has autism and requires constant supervision when his parents are not with him. Because he has a disability, California pays for his access to after school and respite care. But some of the coverage he relies on could go away unless Ko correctly submitted the re-enrollment forms that had come to him in the mail. The forms are for enrollment in Medi-Cal, California’s safety net health insurance program.
“I thought, oh my gosh, this is confusing,” Ko said.
For the many Chinese-speaking families Ko works with as an outreach director for programs that serve children with disabilities, the process would be even more difficult, she knew.
“I imagine that people who don’t speak English will find it difficult to renew,” Ko said.
One-third of Californians rely on Medi-Cal for health insurance, including nearly 4 in 10 children. People may qualify for the program if they have a low income or have disabilities that require a high level of care. Insurance is a lifeline for many families, especially those like Ko who have children with disabilities. During the pandemic, California and other states did not require people to renew their membership in the program, known nationally as Medicaid. That changed on April 1, when California began sending out renewal packets once again. Renewals will be submitted in batches, based on the month members originally applied for Medi-Cal. Each person’s renewal date is different and expiration dates will be indicated on the form.
How to renew your Medi-Cal coverage
Many community health centers and community-based organizations across the state have on-site health navigators and enrollment specialists who can help with Medi-Cal applications and renewals, including in Chinese and other Asian languages.
In the Bay Area, these include Asian Health Services, East Bay Agency for Children, and Korean Community Center of the East Bay (844) 828-225. To find more organizations that offer support in a variety of languages, look here (PDF) starting on page 9.
Over the next year, as the renewal process continues, millions of Californians could lose their Medi-Cal coverage if they don’t fill out the forms correctly or don’t receive them. A March report (PDF) from the state Department of Health Care Services, which oversees Medi-Cal, estimated that 2 million to 3 million Californians could be removed from the program.
Health officials and advocates urge Medi-Cal enrollees to proactively contact their local county Medi-Cal office to update their contact information if it has changed and to be on the lookout for renewal information by mail. The state is also funding outreach campaigns targeting different communities and supporting health navigators who can assist with multilingual and disability renewals. Meanwhile, a children’s advocacy group is pushing to expedite a policy that would give children under 5 enrolled in Medi-Cal continuous coverage without the need for renewals.
Right to request help
Some Californians may lose their Medi-Cal coverage due to a change in their income or other circumstance that makes them ineligible. Instead, these members may be eligible for subsidized health coverage through the state’s Covered California insurance exchange.
But other Medi-Cal recipients will be dropped from the program simply because they moved or changed phone numbers in the last three years and the counties don’t have their current contact information, or because they didn’t fill out the paperwork correctly. often because they don’t understand it. The forms include 15 or more pages of questions about household members, filing status, income, and health care coverage. Some ask for details about the recipient’s assets. The length and content of the forms vary slightly depending on the type of Medi-Cal coverage for which the member is eligible. The forms come pre-filled with information the member has provided in the past, and recipients are asked to confirm or update it.
In addition to Medi-Cal renewals, families with children enrolled in a related health coverage program called California Children’s Services will be sent a renewal form for that program. Children’s Services covers treatment, case management, and physical and occupational therapy for children up to age 21 with certain disabilities or diseases such as cerebral palsy, cystic fibrosis, cancer, heart conditions, and orthopedic disorders.
“I can’t stress enough how big this company is,” said Alicia Emanuel, a senior attorney with the National Health Law Program, which advocates for low-income people’s health rights.
“We are concerned about populations that might go unnoticed. People with limited English proficiency, people with disabilities historically experienced more administrative barriers to retaining their coverage.
Forms can be completed by mail, online, in person, or by phone. People with disabilities or limited English proficiency have the right to request assistance in person to complete their paperwork. People can also request forms and help in one of 19 languages, including Chinese, Hmong, Korean, and Thai. People with disabilities can get free help from a qualified sign language interpreter and written information in other formats, such as large print, audio, or accessible electronic formats. (See the resources in the shaded box above, or find the contact information for your county eligibility worker and other information on your renewal form.) Although these options are available, many people don’t know they can apply for them.
‘A matter of life and death’
Ko said she didn’t even bother calling her county for help with her son’s Medi-Cal renewal, though she had questions, mostly related to whether she needed to fill out the income section since her son qualifies because of his disability, not family income. She had tried calling in the past, including before the pandemic, she said, and was on hold for at least an hour.
“You’re on hold and then they transfer you to another line and you’re on hold some more,” he said. “I try to avoid it because it takes too long.”
Wendy Neikirk Rhodes, executive director of Support for Families, which serves families of children with disabilities in San Francisco, said many families are very concerned about the renovations.
“The concern is so great because many times the lives of their children depend on medical treatment,” she said. “The financial viability of their families, the health and well-being of their children, all depend on their being able to access the Medi-Cal services to which they are entitled.”
Kanit Therdsteerasukdi of Fremont requested her son’s form in Thai because his wife does not understand English well. However, even in Thai, the form made no sense to her because it was poorly translated, she said. She ended up looking at older forms in English that she had filed away to figure out how to answer the questions.
Advocates are pushing for the state to expedite a policy enacted last year in California that would allow continued coverage for children enrolled in Medi-Cal from birth to age 5, beginning in 2024. Mayra Alvarez, CEO from Children’s Advocacy organization The Children’s Partnership said automatic renewals during the pandemic dramatically reduced the number of children who lost access to Medi-Cal.
“We hope to put more pressure on the administration to move forward with the implementation of that policy as quickly as possible,” he said. “Medi-Cal is a lifeline for many in our community. It’s literally a matter of life and death.”
After putting off completing her son’s Medi-Cal renewal for a week, Ko gathered the income and insurance documents she needed and dug through her files for a previous renewal form to help answer some of the questions she wasn’t sure about. safe. A few days later, she drove to the local post office and mailed the form back. She still wasn’t entirely sure she filled it out correctly, but she hopes for the best.
“I filled it out the best I could,” he said.