Merced County experiences backlog of Medi-Cal applications, leading to delay of health benefits

Merced residents who enroll in Medi-Cal may have to wait months before they can take full advantage of their new health care benefits.

The Human Services Agency revealed last week that it is still processing Medi-Cal applications that were filed in October.

According to federal and state guidelines, processing Medi-Cal applications generally should be completed within 45 days of receipt. But with the Affordable Care Act’s expansion of Medi-Cal, many counties have experienced an influx of applications.

Corrina Brown, HSA program manager, explained that applications were not immediately referred to the counties for processing. Instead they had to be sent first through Covered California to determine eligibility for Medi-Cal. Once eligibility was confirmed the applications were sent to the county.

“These referrals from the state are our priority” she said, “and we are working through them as quickly as we can.”

According to Mary-Michal Rawling, Golden Valley Health Centers program manager, the backlog is putting pressure on enrollment counselors inundated with questions from people who are unable to get in touch with their human services caseworker.

“People are becoming upset because they are not hearing back from their caseworker, and we’ve been trying to explain that the county is backlogged,” Rawling said. “But we can’t point fingers at the county. I think there’s just a lot of moving parts and everyone is just trying to move forward.”

Rawling believes many of the applicants’ concerns may be caused by a misunderstanding of the expanded coverage.

At last week’s Merced County Health Care Consortium meeting, Veronica Chavez, an enrollment counselor at GVHC, said she has assisted people who reported being told by “people at the county” that their Medi-Cal application may be denied because they do not have any dependent children.

According to ACA regulations, as of Jan. 1, single adults between 19 and 64 without children are eligible to apply for Medi-Cal.

Brown said the agency is looking into the communication issue.

“We’re going back and checking with our sources,” Brown said. “It seems there are some communication hiccups, but we’re definitely checking it out. The real message here is that the community needs to ensure that the person they are working with is a qualified eligibility worker.”

“The ACA is a huge transition, and there is still messaging that needs to be improved,” she added.

Because Medi-Cal enrollment is open year-round, HSA continues to receive applications.

Medi-Cal applicants who have questions regarding the status of their application can contact the Merced County HSA at (209) 385-3000.