(SAN BERNARDINO, Calif.) Seniors and people with a disability wth Medi-Cal may soon face a change in their health care plan because of new federal legislation.
This legislation allows 12 California counties, including San Bernardino and Riverside to require most Medi-Cal patients who are seniors (age 65 and over) or who have a disability to enroll in Medi-Cal Managed Care. These 12 counties began moving their Medi-Cal patients into managed care plans on Wednesday, June 1.
In managed care plans, patients must select a primary care physician, such as one of the doctors at LaSalle Medical Associates. The primary care physician must approve all treatments and refer patients to specialists or hospitals when necessary.
“Managed care plans make it easier for you to get the best care possible,” said Dr. Albert Arteaga, CEO of LaSalle Medical Associates. “Within both of the managed care plans available to our patients, there are programs to help you stay healthy no matter your age or disability.”
In the Inland Empire, the managed care plans are Inland Empire Health Plan (IEHP) and Molina Healthcare of California Partner Plan, Inc. Affected Inland Empire patients have a choice between these two managed care programs to participate in, but if they do not pick one of the plans, Medi-Cal will make the choice for them.
There are some exceptions also. Those who receive Medicare, have already been diagnosed with a long-term illness or have other health insurance won’t be able to join a managed care plan, nor will foster children with disabilities.
Most young, Medi-Cal recipients without a disability have been required to choose a managed care plan since 1997, according to Consumers’ Union. Elderly and disabled Medi-Cal recipients have until now had a choice.
The option no longer available is “fee-for-service” or “Straight Medi-Cal”.
“Fee-for-service has several disadvantages,” said Dr. Arteaga. “Most importantly, if a patient sees many different health care providers, none of them have a complete idea of the patients’ medical history. Knowing this history is very important in preventing small problems from robbing you of your independence.”
“Going to the emergency room for colds and sniffles is like turning on a fire hose to water your house plant,” Dr. Arteaga said. “Using a watering can works better for most house plants. Seeing a regular doctor works best for people, unless they have broken bones or some other serious health condition requiring immediate attention. Even in some of those cases, managed care can help them become aware of a potential problem before it becomes a life-threatening condition.”
About LaSalle Medical Associates
LaSalle Medical Associates, Inc., operates four clinics employing more than 120 dedicated healthcare professionals, treating children, adults, and seniors in San Bernardino County. LaSalle’s patients are primarily served by Medi-Cal and they also accept Blue Cross, Blue Shield, Molina, Care 1st, Health Net and Inland Empire Health Plan (IEHP). LaSalle’s clinics are at 17577 Arrow Blvd. in Fontana, 16455 Main St. in Hesperia and 1505 West 17th St. and 565 N. Mt. Vernon Ave. in San Bernardino.
LaSalle Medical Associates, Inc., is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals and clinics, delivering high quality care to more than 245,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino, San Joaquin and Tulare Counties.
LaSalle’s IPA members in the Inland Empire include: LaSalle Medical Associates, Arrowhead Orthopedics, Arther Medical Group, Rancho Medical Group, Rancho Paseo Medical Group, Alessandro Medical Group Banning Medical Group, and San Bernardino Urological Associates. Hospital affiliations include: Rancho Springs Medical Center, Arrowhead Regional Medical Center, Community Hospital of San Bernardino, St. Bernadine Medical Center, Mountains Community Hospital, Redland Community Hospital, Loma Linda University Medical Center, Corona Regional Medical Center, Riverside County Medical Center, Parkview Community Hospital.