Webinar recorded live June 25, 2020

Overview

Who does the Medi-Cal program cover?
How does one become eligible for Medi-Cal?
How does an individual get enrolled in a Medi-Cal Managed Care plan?

The Medi-Cal program is critically important to more than 13 million Californians — 10.6 million of whom receive their health services through managed care. But despite its broad reach, not everyone is eligible for Medi-Cal. Because the program is jointly funded and administered by the federal and state governments, specific eligibility requirements must be met and verified before individuals can access and receive care. Such eligibility information, which is procured through the application and verification processes, provides health plans with vital information about the characteristics and needs of the members they serve.

Listen in to this introductory webinar and learn more about Medi-Cal eligibility and enrollment, including who’s eligible, the different pathways to eligibility and enrollment, how the enrollment process works, and how individuals are assigned to and enrolled in a managed care plan.

Recording

Watch the webinar
The password to access the recording can be found in your registrant recording notification email.

Materials

Download presentation materials

Download Glossary of Health Care Acronyms

Additional Resources

Presumptive Eligibility Resources

• Overview of Presumptive Eligibility Programs

Key types of presumptive eligibility commonly utilized in California:

•  ​​​​​​​Hospital Presumptive Eligibility Program
• COVID-19 Presumptive Eligibility Program
• ​Presumptive Eligibility for Pregnant Women
• Child Health and Disability Prevention Program

Faculty

Cathy Senderling-McDonald
Deputy Executive Director
California Welfare Directors Association

Cathy Senderling-McDonald is the Deputy Executive Director of the County Welfare Directors Association (CWDA) where she works to promote legislative, budget and policy changes that improve human services programs and the delivery of those services. Prior to joining CWDA, she served as the California Senate Budget Committee consultant for social services programs, as well as a fiscal and policy analyst for the California Legislative Analyst’s Office. She has a bachelor’s degree in journalism from the University of Missouri at Columbia and a master’s degree from the Heinz School of Public Policy and Management.

Thomas Pham
Vice President of Strategy
Inland Empire Health Plan

Thomas Pham, VP of Strategy for Inland Empire Health Plan (IEHP), leads the development and facilitation of IEHP’s strategic planning process and oversees the diversification and implementation of new products and new business. He is also responsible for strategies to improve and enhance IEHP’s existing products and membership growth.

In his most recent role as Senior Director of Marketing and Products, Thomas managed the Communications and Marketing, Product Management, Medi-Cal Enrollment and Medicare DualChoice Enrollment teams. 

Thomas received a Master’s in Public Health with an emphasis in Healthcare Administration from Loma Linda University and bachelor’s degrees from the University of California, Los Angeles.

Carolyn Thon
Member Services and Outreach Director
Health Plan of San Mateo

Carolyn Thon is currently a Project Manager for Customer Support at the Health Plan of San Mateo (HPSM). She has been with HPSM since July 2005. Carolyn was previously the Chief Support Officer at HPSM. She was responsible for customer support, including member call centers, eligibility and outreach, grievance and appeals and enrollment/disenrollment for HPSM’s Duals Special Needs Plan and Medicare-Medicaid Cal MediConnect program.

Before joining HPSM, Carolyn worked for 25 years with the County of San Mateo. Carolyn held numerous financial and administrative management positions at the San Mateo Medical Center, the County’s public hospital and clinic system. Among her responsibilities were the hospital and clinics revenue cycle (patient access and eligibility and patient financial services), case management and utilization management, medical records, quality improvement and Joint Commission preparation. She also served as the fiscal officer for ambulatory care services and oversaw the County’s Healthcare for the Homeless federal grant.

Carolyn has an MPA from Syracuse University and a BA in Political Science from Pitzer College.

System Testing Instructions

Troubleshooting Connectivity Issues
We recommend following the steps below to resolve any technical issues prior to the start of the webinar:

1. Download the Adobe Connect app for optimal performance.
2. Test your computer’s compatibility in advance of the webinar.
3. For optimal viewing, please ensure you have installed a relatively up-to-date version of Adobe Flash Player.
4. Close all applications other than what is needed to view the webinar.
5. If your continue to experience problems, try using a different web browser and/or refer to these troubleshooting tips.