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Coping with Medi-Cal Reductions

Money and medication

On July 1, 2009, Medi-Cal reduced services for dental care, speech therapy, and other special types of health care. Medi-Cal is a state program that offers free health care services to qualifying individuals in California. Most of the people you support probably use Medi-Cal to pay for their health care services. Regional Centers may pay for some of the services Medi-Cal will not pay for based on the person you support’s Individual Program Plan (IPP). Contact your local Regional Center for more information. The people you support may have a hard time adjusting to the new limits on services. Here are some ways you can help them to stay healthy:

Oral Health

If the people you support (adults over 21) live in a licensed nursing home or sub acute facility, they will continue to receive dental services through Medi-Cal. However, if they live with their families, in the community, or in independent living, their dental services will not be paid for by Medi-Cal. You can support these people by:

  • Encouraging them to brush their teeth twice a day
  • Showing them how to brush their teeth the right way
    • Reaching all the parts of their teeth
    • Brushing for two minutes
  • Encouraging them to floss their teeth
  • Contacting their dentist immediately, if the person you support has dental pain

Eye Health

Medi-Cal will no longer pay for or replace eyeglasses for people with low vision. You can help the people you support by taking good care of the glasses they have by:

  • Cleaning the lenses with a micro fiber cloth made for eyeglasses. Taking good care of the cloth by keeping it in a protective case so it does not get dirty or lost
  • Washing eyeglasses with regular soap and water. Do not use a harsh sponge on the lenses
    • Using a small screwdriver to regularly tighten frames to make sure the lenses do not fall out
    • Encouraging people to keep their glasses in a hard, protective container when not wearing them

Hearing Health

Under the new Medi-Cal rules, hearing tests will no longer be paid for. However, Medi-Cal will still pay for new or replacement hearing aids. To find out what hearing services can be paid for, contact your local Regional Center. You can continue to help by paying close attention to the people you support by:

  • Watching for signs of hearing loss, if the person you support has trouble hearing the doorbell or asks you to repeat something many times
  • If you suspect that a person you support has hearing loss, you can test them for free online (see Resource Links for Better Living on the back)
  • If you think someone you support needs a hearing aid, you should make an appointment with a doctor or an audiologist (ear specialist)
  • If someone you support has a hearing aid, but it isn’t working well, check the battery.

Mental Health

Under the new rules, some psychology services may no longer be paid for by Medi-Cal. Psychology services include counseling, therapy, and drugs for mental health. Regional Centers may pay for some of the psychology services not paid for by Medi-Cal. Contact your local Regional Center service coordinator for assistance. Click here to find your local regional center. Consider the following things to help the people you support stay healthy:

  • Ask your doctor about the Medi-Cal changes. Medi-Cal may continue to cover mental health services if you are currently receiving them
  • Ask your local county health department if they can provide any of the benefits and services no longer covered by Medi-Cal. Click here to find your county mental health department.

What are Direct Support Professionals (DSP) saying about the Medi-Cal reductions: [Thanks to Scott Wellington, Laura Sanders, and Christine McCormick]

  • Talk to the individual’s Regional Center service coordinator about covered services.
  • Some individuals insured under Medi-Cal will still be able to receive the free health services. For example, individuals on Medicaid waivers can still use community dental clinics in some counties. Check with your local county health department for more information.
  • Speak with advocates for people with developmental disabilities about your options.
  • Ask local medical or dental providers if they would provide free or discounted health care.
  • When you do go to the doctor, be prepared for every visit. Take a list to make sure you remember everything you want to talk about with the doctor.

Remember: It’s flu season!

Are you prepared for flu season? Make sure that the people you support stay healthy this winter. Help them to get flu shots and be prepared for a possible H1N1 (swine flu) outbreak. This year people may need two shots, one for the regular flu and one for swine flu. Due to the H1N1 flu, it is especially important this year to avoid spreading the flu by washing hands and staying home if you get sick. Learn more about the flu and the H1N1 virus by following these links:

  1. Questions & Answers: H1N1 Virus
  2. Preventing Seasonal Flu With Vaccination

Download the attached newsletter to learn more about how to cope with the Medi-Cal reductions.

Download: 
application/pdf icon2009 Fall Newsletter

Last updated on April 26th, 2010

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