Health Net Alerts for Medi-Cal

Testing can be ordered only by physicians or other authorized health care providers. Members seeking testing for COVID-19 should consult with their physician or health care provider who may order the test if they determine the patient meets testing criteria.

How is Health Net addressing potential technical issues?

We have thorough Business Continuity Plans in place for our IT systems, Call Centers and other operations. Health Net and Centene offices remain open, with essential personnel in place. We have implemented appropriate technology, and work from home capabilities for the majority of our employees under HIPAA/PHI/PII compliance guidelines. There are no changes to business hours.

Where can I obtain the latest information and guidance on COVID-19?

For more information about COVID-19 and the latest guidance from public health officials visit any of these websites:

• California Department of Public Health
• Centers for Disease Control and Prevention
• World Health Organization

On March 19, 2020, the state of California launched a new coronavirus awareness website. According to this website:

• California is expanding the coronavirus testing capacity daily.
• Currently, testing is being prioritized for people who have the coronavirus symptoms AND have one of these risk factors:
  • Have had contact with a person who has tested positive for COVID-19, OR
  • Are health care providers or work with vulnerable populations (such as a long term care facility), OR
  • Traveled to an affected country in the past 14 days, OR
  • Are over age 60, have a compromised immune system or have serious chronic medical conditions

Will Health Net allow access to telehealth services to increase access to care?

To limit members' risk of COVID-19 infection, Health Net encourages use of telehealth to deliver care when medically appropriate and capable through telehealth modalities for all services.

What is Health Net doing to help make sure members continue to get needed health care services, while practicing social distancing?

Health Net covers all telehealth services that are associated with COVID-19 for its members, as well as all covered healthcare services that can be administered virtually during the COVID-19 crisis.

Also, Health Net put together a COVID-19 taskforce to identify, and is reaching out to members who are at high risk for COVID-19. The purpose of the outreach is to connect with identified high-risk members and confirm they have access to the support and services they need. The taskforce began making outbound calls to this membership at the beginning of April.

In addition to the above, our parent company, Centene Corporation is:

• Facilitating the sourcing, ordering, and shipping of personal protective equipment (PPEs) to our provider partners that enable them to meet the urgent needs of patients. Centene is already in the process of expediting the distribution of approximately 2 million pieces of PPE including safety goggles, facemasks, hand sanitizers and disaster kits, and will continue these efforts in coming weeks.
• Partnering with our providers to deploy resources to service areas that have been most impacted by newly created quarantine and isolation centers.
• Providing data and support that enable providers to reallocate resources based upon utilization changes caused by the COVID-19 pandemic.
• Working to ensure that our community Safety Net providers and organizations have long-term sustainability beyond the immediate crisis.
• Providing assistance in securing small business loans to specifically help behavioral health providers and community-based behavioral health organizations, long-term service support organizations and other Safety Net providers gain access to government-sponsored small business loans, and telehealth technology.

Are there any costs for getting COVID-19 screening and testing?

Health Net covers screening and testing for COVID-19 for Medi-Cal members.

If I have been laid off from work, what kind of health coverage can I qualify for?

Standard Policy COBRA and state continuation protocols apply if one or more employees are terminated as a result of COVID-19. Health Net will offer assistance in alternative enrollment options, including Individual & Family Plans (IFP) and Medi-Cal.

Is Health Net waiving costs for COVID-19 related treatments?

Effective immediately, Health Net will waive any member costs for COVID-19 related treatments for Medi-Cal members.

Is Health Net waiving prior authorizations for COVID-19 related treatments?

Effective immediately, Health Net and its delegated entities will waive prior authorizations for COVID-19 related treatments for all Medicare, Medi-Cal and commercial fully insured members. Inpatient admission notification is still required as soon as possible to Health Net and the member's assigned delegated participating physician group (PPG) or IPA, if available.

Added 6/12/20 Will my Medi-Cal benefits end during the COVID-19 emergency?

No. In March, Governor Gavin Newsom gave an order to make sure people keep getting Medi-Cal, CalFresh, California Work Opportunity and Responsibility to Kids, Cash Assistance Program for Immigrants, California Food Assistance Program, and/or In-Home Supportive Services. You can read the Governor's Executive Order N-29-20 on the Office of Governor Gavin Newsom's website.

• Governor's Executive Order N-29-20 (PDF)

If you are in Medi-Cal, you cannot lose your Medi-Cal during the COVID-19 emergency. For exceptions, read Question 4 in the Frequently Asked Questions (FAQ).

Added 6/12/20 I got a Medi-Cal renewal packet. What should I do to keep getting Medi-Cal benefits?

If your renewal date is March 2020 or later, you do not have to do anything right now. You will keep getting Medi-Cal until the Governor's order ends, no matter what your renewal date is or what changes you report. You can send your renewal information, but your county worker might not process it right away.

Added 6/12/20 I got my economic impact stimulus payment from the Internal Revenue Service (IRS). Will this count as income and affect my Medi-Cal eligibility?

No. The COVID-19 economic impact stimulus payment from the federal government does not count as income. It will not affect your Medi-Cal eligibility.

Added 6/12/20 Is there any way I could lose Medi-Cal during the COVID-19 emergency?

Yes. Medi-Cal can end if:

• You die.
• You move out of state.
• You tell your Medi-Cal worker you no longer want Medi-Cal.

Added 6/12/20 Do I need to call my local Medi-Cal county office to make sure I keep getting Medi-Cal during the COVID-19 emergency?

No. But you should call your local county office if your Medi-Cal is not working, you move to a new county, or you need to report a change that may qualify you for a program with more benefits.

Some county Medi-Cal offices may be closed for in-person services for now. You can still contact them by phone, mail, email, or online. You can find your local county office information online at the DHCS listing of County Offices webpage. Or call the Medi-Cal Member and Provider Helpline at 1-800-541-5555 (TTY 1-800-430-7077). Outside of California, call 1-916-636-1980.

• DHCS listing of County Offices

Added 6/12/20 What if I cannot pay my Medi-Cal premium (cost)?

If you cannot pay your Medi-Cal premium during the COVID-19 emergency you can call to get your premium waived (stopped for now).

• For children and pregnant women programs, call 1-800-880-5305.
• For the 250 Percent Working Disabled Program, call 1-916-445-9891.

If your income has dropped, you can also call your county worker. Ask if you are eligible to have no premium.

Added 6/12/20 Can I have a phone or online appointment?

Yes. If your provider has telehealth and you meet the rules for a telehealth appointment, you can get many Medi-Cal services from home. Telehealth includes phone or videoconference appointments. They help lower your exposure to COVID19. You can talk with your doctor by computer or phone for all medically necessary services. To learn more, go to the DHCS COVID-19 Response webpage.

• DHCS COVID-19 Response

If your doctor does not have telehealth and you are in a Medi-Cal managed care plan, you can call the plan. Ask for help to find a provider that has telehealth.

Added 6/12/20 What should I expect in a telehealth appointment?

The standard of care is the same if you see your provider in person or with telehealth. If your provider has telehealth and decides you can get telehealth treatment for your problem, they will set up the appointment by phone, videoconference, email, or online chat. Call your health care provider to ask how telehealth works and how to make a telehealth appointment.

Added 6/12/20 If I have COVID-19 symptoms, how much will it cost to get tested? If I am COVID-19 positive, how much will treatment cost?

Medically necessary COVID-19 testing, testing-related services, and treatment are free with Medi-Cal. When the visit is to get screened, tested, or treated for COVID19, services are covered for emergency room, urgent care, and provider office visits.

Added 6/12/20 Who should I call if I have COVID-19 symptoms?

If you have any of these emergency warning signs for COVID-19, get medical help as soon as you can:

• Trouble breathing
• Long-lasting pain or pressure in the chest
• New confusion or you can't wake up
• Blue lips or face

This list is not complete. You can read the entire list of symptoms on the CDC webpage.

• List of COVID-19 symptoms from CDC

Call 911 if you have a medical emergency. Tell the operator you have or think you might have COVID-19. If you can, put on a cloth face cover before help arrives. Call your doctor if you have other symptoms that are severe or worry you. Also call your doctor if you have mild symptoms such as cough, fever, loss of taste or smell, headache, fever or long-lasting high fever, or sore throat.

If you are in a Medi-Cal managed care plan, you can call your Primary Care Provider (PCP). Or call your plan's Member Services or Nurse Advice Line. The phone numbers are on your Member Identification Card.

If you are getting services in fee-for-service Medi-Cal and are not in a Medi-Cal health plan, you can talk with a nurse through Medi-Nurse. Call the DHCS COVID Line at 877-409-9052.

Added 6/12/20 I am in restricted-scope Medi-Cal and/or my immigration status has not been verified. Can I get Medi-Cal services related to COVID-19?

Yes. All Medi-Cal beneficiaries can get COVID-19 testing, testing-related services, and treatment during this emergency. All Medi-Cal beneficiaries can get medically necessary services for COVID-19 no matter if they are in full-scope or restricted-scope Medi-Cal. (Restricted-scope Medi-Cal is pregnancy or pregnancy-related and emergency services only.) You can get COVID-19-related services in both Medi-Cal managed care and fee-for-service Medi-Cal, regardless of your immigration status.

Federal immigration services have said that COVID-19 testing and treatment does not count in their "public charge" test. More information about "public charge" is available on the U.S. Citizenship and Immigration Services website.

• U.S. Citizenship and Immigration Services

To learn more about public charge, you can also see the California Health and Human Services Agency Public Charge Guide.

• California Health and Human Services Agency Public Charge Guide

Added 6/12/20 I think I need medical care not related to COVID-19. What should I do?

If you need medical care, call your doctor. They can tell you if you should make an in-person appointment. Your doctor may set up a telehealth appointment by phone or video to keep you safe. See Questions 7 and 8 for more on telehealth.

If you need to see your doctor in person, wear a face mask. Try to stay six feet away from other people. If you have severe symptoms and cannot reach your doctor, go to urgent care or the emergency room. Or call 911.

Added 6/12/20 What are "essential services"?

Urgent and emergency treatments and procedures are "essential services." You can get these services during the COVID-19 emergency. They include treatment for severe symptoms, pregnancy-related services, labor and delivery, dialysis, organ transplant, cancer treatments, and trauma services.

You may be able to get other services by telehealth. In some places, your doctor may start giving preventive services in person again. To learn more about resuming deferred and preventative health care, go to the CDPH website.

• CDPH website

You also may call your doctor or managed care plan to find out if your area is starting to give these services in person again, and how to access them.

Added 6/12/20 I have medical appointments that are not urgent. Should I go to them?

Talk with your doctor about whether to reschedule or use telehealth for non-urgent appointments. Your doctor will decide if it's best to keep your appointment in person, use telehealth, or wait until after the COVID-19 emergency.

If you are in a managed care plan, you can call your provider or health plan to find out if your area is giving these services in person again. You can also learn when and how to get them. To learn more, go to the DHCS website for guidance on nonurgent, non-essential or elective procedures relative to 2019 COVID-19.

• DHCS website - guidance on nonurgent, non-essential or elective procedures relative to 2019 COVID-19 (PDF)

Added 6/12/20 I'm having trouble reaching my doctor. What should I do?

Some offices in your area may be closed for now due to the COVID-19 emergency.

If you are in a managed care plan, call your health plan to find out your choices. Your health plan can help you find the best way to get medical care. If you need more help, call the DHCS Ombudsman, Monday through Friday, 8 a.m. to 5 p.m. at 1-888-452-8609. The call is free.

If you get services in fee-for-service Medi-Cal and are not in a Medi-Cal health plan, you can get help to find a Medi-Cal provider. Call the DHCS COVID Line at 877-409-9052.

Added 6/12/20 My child under age 21 is due for a checkup. What should I do?

Call your child's doctor. Ask about ways your child can get routine care like well-child visits and immunizations (shots). The doctor should explain their changes to the clinic or office so your child can be seen safely in person. Or they may offer to see your child and do a medical check by phone or telehealth. For telehealth, you may need to bring your child to the office or clinic later for a follow-up exam or shots.

Well-child visits and regular checkups are an important way to track your children's growth and development. With the stay-at-home rules, DHCS understands that you may worry about taking your child to the doctor or clinic. To make sure your child gets exams and shots, call your child's doctor to talk about your choices.

Added 6/12/20 I need to see a dentist. What do I need to do to get treatment?

If you have dental pain or a dental emergency, call your dentist's office. If you do not have a dentist or your dental office is closed or cannot see you, call the Medi-Cal Dental Telephone Service Center. They can help you find a dentist. Their number is 1-800-322-6384.

Added 6/12/20 How do I know if I have a dental emergency?

A dental emergency needs treatment right away. Here are some examples:

• Bleeding from the mouth that does not stop
• Large swelling inside the mouth or on the face
• Facial trauma, such as injury to the jawbone and face
• Severe pain from teeth, gums, or jaw

A routine dental visit is not an emergency. Here are examples of non-emergencies:

• Your first or yearly dental exam and x-rays
• Dental cleaning and preventive treatment like sealants
• Orthodontic treatment
• Non-emergency extractions
• Other dental treatment, such as cavities with no pain

To get updates and learn more about your dental benefits, go to the Smile California website.

• Smile California

Is mental health covered as related and unrelated, to COVID-19?

Mental health is covered through telehealth, whether COVID-19 related or not.

Is coping assistance offered to members impacted by COVID-19?

Members impacted by COVID-19 may contact MHN, our behavioral health subsidiary, for referrals to mental health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss, or other trauma resulting from COVID-19. For the duration of the COVID-19 public health emergency period and its immediate aftermath, affected members may contact MHN 24 hours a day, seven days a week at 1-800-227-1060, or the telephone number listed on the member's identification (ID) card.

Added 6/12/20 I would like to talk to a mental health professional about how I am feeling. Where can I find mental health services?

Medi-Cal covers mental health services. You can find out about and get care during the emergency by telehealth, phone, or in person if needed. If you are in a Medi-Cal managed care plan, call your plan's Member Services on your Member Identification Card. There may be a separate number for mental health services.

If you do not get Medi-Cal through a managed care plan, have severe mental health needs, or got services before through a county mental health plan, you can call your county access line for help with mental health or addiction treatment.

You can find your county access line for mental health on the DHCS County Mental Health Plan Information website.

• DHCS County Mental Health Plan Information

Added 6/12/20 If I or someone in my household has a mental health crisis, how can we get help?

If you or someone in your household is in crisis, whether you are in Medi-Cal or not, you can talk to trained counselors by phone.

• 24-hour Suicide Prevention Lifeline: Call 1-800-273-8255, or text 838255.
• 24-hour Domestic Violence Hotline: Call 1-800-799-7233.
• 24-hour Crisis Text Line: Text HOME to 741741.
• If you or the person you are helping is in immediate danger, call 911.

Added 6/12/20 If I or someone in my household is struggling with substance use, including use of alcohol or other drugs, how do I get help?

Medi-Cal covers substance use treatment services. You can get services by telehealth, phone or in person if needed.

To find your county access lines for substance use treatment, go to the DHCS Substance Use Disorder County Access Lines webpage.

• DHCS Substance Use Disorder County Access Lines

Or call the national treatment help line at 1-800-662-HELP (4357).