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TO LEGAL GEMS. Is there a limit to how many months a Medi-Cal

Resolved Question:

TO LEGAL GEMS. Is there a limit to how many months a Medi-Cal beneficiary may travel out of the country in a year?
Submitted: 1 year ago.
Category: Estate Law
Expert:  RayAnswers replied 1 year ago.

Thanks for your question and good day to you.Your other expert was offline here so let me assist you today.

There is no limit for the number of times or length of stay that you may travel out of country and recieve MediCal here.As you know there would be no medical cover age while out of country such as Mexico.If you are within the US but out of state you may have some coverage here in emergencies.

If you look at this pamphlet it goes over this situation--see item 23 here it covers what I discussed above.Overall MediCal does not care if you leave the country, they are saving money by not having to pay for your medical care.


http://www.sfhp.org/files/PDF/community/assistor_resources/reference_materials/What_Medi-Cal_Means_To_You_Brochure_Medical.pdf


It is other programs like unemplyment where leaving the country for periods of time that would affect benefits.Here it would not affect your MediCal here in California.

It has been my pleasure to assist you today.Please let me know if you have more follow up.Thanks again.

 

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This communication does not establish an attorney-client relationship.Information provided here is not legal advice. Rather it is simply general information.

Expert:  LegalGems replied 1 year ago.
Hi. Thanks for requesting me again. Sorry for the delay - I was researching this and found the answer Please see www.healthconsumer.org/Medi-CalOverview2008Ch2.pdf - I am working remotely so am not able to link you to this but if you enter the above into the search bar you will find it - please see page 2-14: "A beneficiary's absence from the state for sixty days or less is presumed to be a temporary absence and will not affect residency. An absence of more than sixty days is presumed to indicate an intent to change residence, but a beneficiary may rebut that presumption". If they determine your absence has resulted in a change of residency, you can appeal it; the standard is a preponderance of evidence - and the proof required is an intent to remain indefinitely in the state.
California Code Regulations Title 22, 50320 et seq
If an appeal is the ultimate outcome, evidence that would help show your intent to remain in the state would include a long-term lease, voter's registration, etc.

If you have any questions on the above, it may take up to 12 hours for me to respond, as I am traveling. But I believe that the above information should answer your questions for now. Take Care!

Customer: replied 1 year ago.

As I currently have healthnet as my health insurance would the same rules apply? Healthnet is my medicare advantage plan as I am both on medicare & Medi-Cal.

Expert:  RayAnswers replied 1 year ago.

This is the restriction you likely signed when you applied..

Health Net serves a specific service area. If I move out of the area that Health Net serves, I need to notify the plan so I can disenroll and find a new plan in my new area. Once I am a member of Health Net, I have the right to appeal plan decisions about payment or services if I disagree. I will read the Evidence of Coverage document from Health Net when I get it to know which rules I must follow to get coverage with this Medicare Advantage plan. I understand that people with Medicare aren’t usually
covered under Medicare while out of the country except for limited coverage near the U.S. border.
I don't think you would have problems with temporarily being out of country here --jsut no coverage.If you decide to stay you would have to notify them.
Thanks for your follow up.
RayAnswers, Attorney
Category: Estate Law
Satisfied Customers: 29191
Experience: Texas lawyer for 29 years in Estate law
RayAnswers and 6 other Estate Law Specialists are ready to help you
Expert:  RayAnswers replied 1 year ago.
I found this for you about page six it covers yourlimitned benefits outside of country.

http://www.healthnet.com/static/custom/unprotected/pdfs/6019012_travel_guide.pdf

Good luck here..
RayAnswers, Attorney
Category: Estate Law
Satisfied Customers: 29191
Experience: Texas lawyer for 29 years in Estate law
RayAnswers and 6 other Estate Law Specialists are ready to help you

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