Patient Access Updates

Patient Access Training Corner

February 2014 Volume 2

Covered California and the Affordable Care Act

The Affordable Care Act is a Federal Program that is managed by each state. In California, the program is referred to as Covered California.  These commercial insurance plans are offered to eligible Californians as a part of the Affordable Care Act implementation. 

Sample Covered California Insurance Cards

In the county of San Diego there are five participating health plans.  UCSD is contracted with two plans.  These plans are Anthem Blue Cross all four major plans and HealthNet Bronze only. Open enrollment for these plans began October 1, 2013 and will end March 31, 2014.
There are four major levels of coverage which are bronze, silver, gold and platnium.  These coverages do not account for Catostropic Plans. 

Medi-Cal Expansion Program (MAGI)

As of January 1, 2014 all Low Income Health Plan (LIHP) patients should be auto-enrolled into a Medi-Cal Managed Care Plans.  For more information on Covered California select the link below.

RTE Responses for Replacement Plans

Medi-Cal Replacement Plans

When a patient presents with Medi-Cal coverage (1) and RTE is used to verify the coverage it is important to review the Alerts (2) within the RTE response.  When the Alerts indicate a replacement plan, ALWAYS ignore the response (3).  After ignoring the response add the correct replacement plan, run RTE again, and add the correct coverage.