This story originally appeared in the California Health Report and was produced in partnership with News for Chinese, which published a Chinese-language version.
Kelly Ko of Freemont stared at the stack of paper. He had arrived in the mail, from the local government, in a large envelope. Inside was a tortuous 19-page form asking for her family’s exact income, tax return status, expenses and deductions, and details about their existing health insurance. He didn’t know how to answer all the questions.
And her son’s well-being depended on her filling correctly.
Kos’ son Darren, 17, has autism and requires constant supervision when his parents aren’t with him. Because he has a disability, California pays for his access to after-school and respite care. But some of the coverage he depends on could slip away unless Ko properly submitted the re-enrollment forms that had arrived 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.
She knew that for the many Chinese-speaking families Ko works with as program director for children with disabilities, the process would be even more difficult.
I can imagine people who don’t speak English would have a hard time renewing themselves, Ko said.
One-third of Californians rely on Medi-Cal for health insurance, including nearly 4 out of 10 children. People may qualify for the program if they are 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 renewal packages again. Renewals will be sent in batches, based on the month enrollees originally applied for Medi-Cal. The renewal date of each one is different and the expiration dates will be indicated on the form.
How to renew your medical coverage
Many community health centers and community-based organizations across the state have health navigators and on-site 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 other organizations offering assistance in a variety of languages, search here (PDF) starting on page 9.
Over the next year, as the renewal process continues, millions of Californians could lose medical coverage if they don’t fill out forms correctly or don’t receive them. Areport (PDF) in March by the state Department of Health Services, which oversees Medi-Cal, estimated that between 2 million and 3 million Californians could be excluded from the program.
Health officials and advocates are urging 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 in the mail. The state is also funding awareness campaigns targeting different communities and supporting health navigators who can help with renewals in various languages and for people with disabilities. Meanwhile, a children’s advocacy group is pushing to speed up a policy that would give kids under 5 enrolled in Medi-Cal continued coverage without the need for renewals.
A right to ask for help
Some Californians may lose their medical coverage due to a change in income or other circumstances that make them ineligible. Instead, these enrollees 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’ve moved or changed phone numbers in the past three years and counties don’t have up-to-date contact information, or because they don’t fill out the paperwork correctly—often because they don’t understand it. . Forms include 15 or more pages of questions about living household members, tax return status, income, and health coverage. Some ask for details about a recipient’s assets. The length and content of the forms vary slightly depending on the type of Medi-Cal coverage the member is eligible for. Forms are pre-populated 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 Childrens Services will be sent a renewal form for that program. Children’s services cover treatment, case management, and physical and occupational therapy for children up to age 21 with certain disabilities or illnesses such as cerebral palsy, cystic fibrosis, cancer, heart conditions, and orthopedic disorders.
I can’t stress enough how big this commitment is, said Alicia Emanuel, a senior attorney with the National Health Law Program, which advocates for the health rights of low-income people.
We were concerned about populations that might fall through the cracks. People with limited English proficiency and people with disabilities have historically experienced greater administrative hurdles in maintaining their coverage.
Forms can be completed by mail, online, in person, or over the phone. Persons with disabilities or limited English language proficiency have the right to request in-person assistance to complete paperwork. People can also request forms and help in one of 19 languages, including Chinese, Hmong, Korean and Thai. People with disabilities can get the free help of 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 look for contact information for your county eligibility worker and other renewal form information.) While these options are available, many people don’t know they can apply for them.
A matter of life or death
Ko said she didn’t even bother calling her county for help with her son’s medical renewal, even though she had questions mostly related to needing to fill out the income section since her son qualifies due to his disability not the household income. . She had tried calling in the past, even before the pandemic, she said, and had been on hold for at least an hour.
You’re on hold and then they transfer you to another line and you’re still on hold, she said. I try to avoid it because it takes too much time.
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 renewals.
The concern is so high because many times their child’s life depends on medical care, she said. The financial viability of their families and the health and well-being of their children all depend on their ability to access the medical services to which they are entitled.
Kanit Therdsteerasukdi of Fremont asked his son to speak Thai because his wife does not understand English well. However, even in Thai the form of her didn’t make sense to her because it wasn’t well translated, he said. He ended up going through old English forms 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 for uninterrupted coverage of children enrolled in Medi-Cal from birth through age 5, starting in 2024. Mayra Alvarez, executive director of the Childrens L advocacy organization, The Children’s Partnership, said automatic renewals during the pandemic have dramatically reduced the number of children losing access to Medi-Cal.
We hoped to put more pressure on the administration to move forward with implementing that policy as quickly as possible, he said. Medi-Cal is a lifeline for so many in our community. It is literally a matter of life and death.
After putting off filing her son’s Medi-Cal renewal for a week, Ko gathered the income and insurance documents she needed and searched her files for an old renewal form to help her answer some of the questions. questions she was uncertain about. A few days later she went to the local post office and mailed the form. She still wasn’t quite sure she filled it in correctly, but she hopes for the best.
I have compiled it to the best of my ability, he said.
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