Council on Aging Answers 2016 - 93

Cal-Optima
Launches
OneCare
Connect

COUNCIL ON AGING - ORANGE COUNTY

New Health Plan for Medicare
and Medi-Cal Beneficiaries
Counseling and Advocacy Program) can help you
evaluate whether this program meets your needs.
HICAP can help you:
n Enroll in the OneCare Connect plan
n "Opt-Out" of the OneCare Connect plan before
the passive enrollment date
n Drop enrollment in OneCare Connect plan
n Continue to receive Original Medicare benefits
(Parts A+B) plus a part D prescription drug plan
and fee-for-service Cal-Optima (Medi-Cal)
n Enroll in a Medicare Advantage Plan that includes
Part D benefits.
Facts to consider before making a decision:
n Does your primary care physician accept OneCare
Connect?
n Do your specialists participate in OneCare
Connect?
n Are your prescriptions included in OneCare
Connect's formulary?
For additional information contact the HICAP Call
Center at (714) 560-0424 to discuss your questions
or schedule an appointment at your local senior/
community center.
HICAP is a State and Federally Mandated Program
that Provides Free, Unbiased Medicare information.

Council On Aging-Orange County | 714-479-0107 | www.coaoc.org	 Answers Guide 2016

93

INSURANCE

Effective July 1, 2015, Cal-Optima, the Medi-Cal
program for Orange County launched a new health
plan for Medicare and Medi-Cal beneficiaries. The
OneCare Connect plan is part of the State of California's
Coordinated Care Initiative that was created with the
implementation of the Affordable Care Act also known
as "Obamacare."
The OneCare Connect health plan, a Dual Special
Needs Medicare Advantage Plan, has a network of
primary care and specialist providers to meet the
healthcare needs of people who have Medicare (both
parts A&B) as well as full scope Medi-Cal (without
share-of-cost). The plan includes a Part D prescription
drug plan and additional benefits such as expanded
dental, vision, transportation and a care coordination
program to assure clients receive the healthcare benefits
they need.
OneCare Connect voluntary enrollment began July
01, 2015. In contrast, passive enrollment of Medicare
and Medi-Cal members with August birthdays began
August 01, 2015, for those who choose to take no action
during the enrollment period. The passive enrollment
will continue by birth month through July, 2016.
NOTE: Persons enrolled in a Dual Special Needs Plan
(D SNP), PACE (Program of All-Inclusive Care for the
Elderly) or a Medicare Advantage Plan (MAPD) are not
subject to passive enrollment in the OneCare Connect
plan. After August 1, 2015, "Medi/Medi" beneficiaries
may not enroll in a Dual Special Needs Plan other than
OneCare Connect.
The Council on Aging's HICAP (Health Insurance


http://www.coaoc.org

Table of Contents for the Digital Edition of Council on Aging Answers 2016

Contents
Council on Aging Answers 2016 - Intro
Council on Aging Answers 2016 - Cover1
Council on Aging Answers 2016 - Cover2
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