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In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. For Medicaid benefits, beneficiaries generally enroll in their state's Medicaid FFS program or a Medicaid managed care plan administered by an MCO under contract with the state.
With 13 million children and adults enrolled, Denti-Cal is the largest state-sponsored dental insurance program Private contractor that administers Denti-Cal is Delta Dental. In 2016, the State of California awarded Delta Dental a new contract to provide administrative services for the Denti-Cal program, continuing the 42-year relationship [ 7 ]
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
C-SNPs are health insurance plans for individuals with specific disabling or severe chronic conditions. C-SNPs were added as Medicare plans after a panel of clinical advisors met in 2008 .
Two state-based health insurance regulators is unusual in the United States, and has led to various additional work to synchronize laws. [3] This dual regulation arose due for historical reasons, and when the DMHC was created in 2000, the California legislature requested a report on merging the health insurer responsibilities with the CDI. [4]
A special needs plan (or SNP, often pronounced "snip") is a category of the US Medicare Advantage plan designed to attract and enroll Medicare beneficiaries who fall into a certain special needs demographic. There are two types of SNPs. The exclusive SNP enrolls only those beneficiaries who fall into the special needs demographic.
Health plans and insurance carriers in a private exchange must meet certain criteria defined by the exchange management. Private exchanges combine technology and human advocacy, and include online eligibility verification and mechanisms for allowing employers who connect their employees or retirees with exchanges to offer subsidies .
The California Health and Human Services Agency (CHHS) is the state agency tasked with administration and oversight of "state and federal programs for health care, social services, public assistance and rehabilitation" in the U.S. state of California.