If you qualify for Medicaid and Medicare, you must take action

paul_bridgewaterMany people considered MI Health Link, the state’s new program that allows some people who qualify for health care and services that are covered by Medicare and Medicaid and lets enrollees use one plan and one card for their health care, home and community-based services, behavioral health care, medications and nursing home care.

The program allows members to have their own care coordinator who will help connect patients to doctors, pharmacies, behavioral health and long-term care support and services through the health plan they select. The care coordinator also is responsible for navigating the process of ensuring doctors and other health care providers are working together to honor members’ choices and to meet patient needs.

However, apparently many people in Macomb and Wayne counties didn’t understand that to enroll and keep their same doctors, pharmacies and other services, they needed to take some action. In April, people who were eligible for MI Health Link should have gotten a letter in the mail from Michigan ENROLLS informing them how to enroll and who to contact for help. A second letter was sent out in June. The plan also allows patients to opt out of the dual eligible plan that began on May 1.

The issue is that people who did nothing will automatically be enrolled in a health plan and it may not be desirable. That means the next time they call their doctor to make an appointment or contact their pharmacy to get a prescription filled, they may be informed that their doctor or pharmacy is no longer serving them. That could be a big surprise for people who like and trust their doctors and want continued care from them or find their current pharmacy convenient.

It’s not too late to do something about it, but the point is you have to respond by mail or make a phone call to Michigan ENROLLS without delay. They need to know if you are enrolling in the program and choosing a health plan or if you are choosing not to enroll at all. But if you do nothing, the choice will be made for you. If choose one and decide you don’t like it, you can change plans or leave MI Health Link anytime you want.

This integrated care means that Medicare and Medicaid will work together to improve the way you get health care, making the process more efficient and the administrative process easier with one card for all services.

You are eligible for MI Health Link if you are at least 21, eligible for full benefits under Medicare Part A, enrolled in Medicare Parts B and D, receiving full Medicaid benefits and live in certain areas of the state. In Metro Detroit, that includes Macomb and Wayne counties.

If you didn’t get a letter, didn’t respond to it or need more information, contact Donna Shellman, the Detroit Area Agency on Agency’s Regional Coordinator for the Michigan Medicaid Assistance Program at (313) 446-4444.

Paul Bridgewater, President and CEO, Detroit Area Agency on Aging (DAAA), hosts “The Senior Solution” on WCHB Newstalk 1200AM, Saturdays at 10 a.m. DAAA is located at 1333 Brewery Park Blvd., Suite 200, Detroit, MI 48207; (313) 446-4444www.daaa1a.org

 

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