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Medi-Cal Renewal Process

Help Members Keep their Medi-Cal Coverage

Overview

The Annual Eligibility Redetermination (AER), also known as the Medi-Cal Renewal Process, is currently underway across our state. This initiative is the biggest challenge facing the Medi-Cal program in its history. 

 

The impact on providers across the entire health care system will be significant, potentially resulting in:

  • Increased use of the emergency department for primary care
  • Decreased capacity of bed availability
    • Delays in hospital discharges while awaiting coverage
    • Increased length of stay for patients with delayed preventative or chronic care
  • Increased cost of care
  • Interruptions of ongoing care

2026 Medi-Cal Policy Changes

Important Reminder - Unsatisfactory Immigration Status (UIS)

Effective January 1, 2026, IEHP members with UIS already enrolled in Medi-Cal will continue to receive full-scope Medi-Cal coverage. However, members 19 years of age or older may risk losing coverage if they allow their eligibility to lapse. It will be important for UIS members who are already enrolled in the Medi-Cal program to renew their coverage in a timely manner. 

 

The Department of Health Care Services (DHCS) has developed a more in-depth informational chart detailing the various immigration categories and the corresponding eligibility coverage available, dependent upon the immigration status of UIS members.

 

To view the chart mentioned and related information regarding this topic, please visit the following:

 

Additional Policy Impact Information 

 

The impact on providers who may experience the loss of UIS members being removed from Primary Care Provider (PCP) panel assignments can lead to :

  • Lower capitation payments
  • Lower targeted rate increase (TRI) payments
  • Lower qualifying Global Quality Pay for Performance payments
  • Specialists and Ancillary providers may see a potential decrease in referral volume 

 

However, with every challenge comes opportunities to help our collective health care mission and partnership grow even stronger.

 

IEHP takes this challenge seriously, and we are committed to helping all IEHP members keep their Medi-Cal coverage, and our provider network keep their assigned members.

 

To review the full statements made by IEHP Chief Executive Officer Jarrod McNaughton, MBA, FACHE, regarding the 2026 Medi-Cal eligibility changes, see below:

 

Resources to Help with the Medi-Cal Renewal Process

The following resources for providers offer more information about the Medi-Cal Renewal Process and tools to help your office proactively engage and encourage all IEHP members to renew their Medi-Cal coverage on time.

 

IEHP will continue to update you as policies related to Medi-Cal eligibility are implemented and share all tools developed to serve you and our members throughout this critical time. 

 

 

Medi-Cal Renewal FAQs, Flyers and Related Information for Providers
Medi-Cal Renewal FAQs and Related Information for IEHP Members
DHCS Policy Resources

IEHP Eligibility Renewal Support Team

IEHP’s Eligibility Renewal Support team is here to answer calls from members needing more one-on-one support during the Medical-Renewal process!

 

Please let your patients and our members know that additional application support is just a phone call away.

 

We support:

  • Application printouts
  • Assistance in connecting with the appropriate county department
  • Serving as a centralized eligibility hub for all eligibility-related issues (on hold, disenrolled, out of area, etc.)
  • Helping members update contact information (national change of address, undeliverable address, etc.)
  • Online submissions via BenefitsCal.com

 

IEHP Eligibility Renewal Support Team Hotline

  • Phone and Hours of Operation: 1-888-860-1296, Monday-Friday, 8 am - 5 pm (PST)
 
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.