Medi-Cal Case Restorations

September 4, 2020

As of August 25, 2020, the Department of Health Care Services (DHCS), in collaboration with counties statewide, has restored all Medi-Cal cases that may have been erroneously discontinued between April 2020 through July 2020.

All restored cases have active Medi-Cal eligibility, with the restoration going back to the first of the month in which they had lost their eligibility. Individuals affected have been placed back into the level of coverage ("no Share of Cost" or "Share of Cost [SOC]") that they had before the negative action erroneously took place. They have also been re-enrolled into their Managed Care Plan or fee-for-service delivery systems, as appropriate. During the week of September 8, 2020, DHCS will be sending out a notice to all impacted individuals to inform them of their reinstatement of Medi-Cal eligibility and plan enrollment along with information on the reimbursement for any out-of-pocket expenditures they may have incurred.

Providers are reminded that Medi-Cal will pay claims for covered medical and/or dental expenses for this population since March 2020.

Medi-Cal beneficiaries may also receive reimbursements for covered medical and/or dental expenses they incurred since March 2020. The Medi-Cal beneficiary is responsible for initiating the out-of-pocket reimbursement claims by calling the Beneficiary Services Center (BSC) at (916) 403-2007. If the beneficiary has a (SOC), please direct them to contact their county office to submit out-of-pocket payments for services. Providers may be contacted for additional information by the BSC for information to support the reimbursement process. Information on the reimbursement process can be found at www.dhcs.ca.gov/services/medi-cal/Pages/Medi-Cal_Conlan.aspx.