Notice of Reduction of Medi-Cal Benefits
(applies to Medi-Cal Adults 21 and older)
FAQs

• Who changed the Medi-Cal covered benefits?
  • 
    Changes were determined by the State of California, effective July 1st, 2009.
  
  
• Are the covered benefits the same for Medi-Cal Beneficiaries versus Health Plan of San Joaquin Medi-Cal Members?
  • 
    

    No.

    Medi-Cal Beneficiaries will be subject to changes recently imposed by the State of California.

    As your managed care plan, we want to partner with you to develop the best plan to improve your health.

    See your primary care physician to determine the appropriate diagnosis and treatment plan.

    To enroll with Health Plan of San Joaquin, please call 1-888-936-7526.

  
  
• What are the exceptions to my covered benefits?
  • 
    

    Adult (21 and over years of age)

    The following are exceptions for eligible Adults:

    1. Members currently residing in a skilled nursing facility
    2. Members who are pregnant
    3. Members receiving California Children Services (CCS)
    4. Members receiving benefits through a program for all-inclusive care for the elderly
    5. Members in the genetically handicapped persons program
    6. Members receiving services from County Mental Health
    7. Members receiving MediCare Part B assistance

    If you have questions about exceptions, please contact the Health Plan of San Joaquin

    Children (under 21 years of age)

    No exceptions. All benefits remain the same.

    To enroll with Health Plan of San Joaquin, please call 1-888-936-7526.

  
  
• Will my children’s medical services continue to be covered?
  • 
    Eligible children receive medical services and are covered up to age 21.
  
  
• What will happen to my dental coverage?
  • 
    

    Adult (21 and over years of age)

    As of July 1st, 2009, these services are no longer a covered benefit by the State.

    Children (under 21 years of age)

    Children continue to receive dental coverage through the Denti-Cal Program.

  
  
• Will I be able to see my Podiatrist?
  • 
    Yes, your doctor will work with HPSJ when these benefits are needed.
  
  
• Will I be able to receive Speech Therapy services?
  • 
    Yes, your doctor will work with HPSJ when these benefits are needed.
  
  
• Can I still obtain incontinence creams and washes?
  • 
    Yes, with a prescription from your doctor.
  
  
• Will I be able to receive Audiology services?
  • 
    Yes, your doctor will work with HPSJ when these benefits are needed.
  
  
• Will my glasses and eye exams continue to be covered?
  • 
    

    Adult (21 and over years of age)

    Eye exams will be covered once every two years and paid for by HPSJ. Eyeglasses and lenses are not covered but can be purchased by the member.

    Children (under 21 years of age)

    Children continue to receive full Medi-Cal vision services from HPSJ.