Medicare AdvantageCoverageMedium impact
24-1307m Find Out What's Changing for Partial Dual Eligible Medi-Cal Members in 2025
Health Net·CA·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Effective January 1, 2025, California's Medi-Cal will pay Medicare Part A premiums for eligible individuals who previously didn't qualify, making them eligible for Dual Eligible Special Needs Plans (D-SNPs). Healthcare providers in specified California counties may see an increase in patients with D-SNP coverage instead of Medi-Cal only.
Action Required
By January 1, 2025: Billing team must verify patient eligibility more carefully as former Medi-Cal-only patients may now have D-SNP coverage. Update patient registration processes to identify D-SNP members. Contact Health Net Provider Services at 800-929-9224 for Medicare Advantage questions or 800-675-6110 for Medi-Cal questions if patient coverage is unclear.