Know Your Rights: Consumer Health Coverage Info

The HCA is a network of ten consumer assistance programs operated by community-based legal services organizations across the state of California. The HCA offers free assistance online, over-the-phone or in-person at independent, community-based offices throughout the state, helping people who are struggling to get or maintain health coverage and resolve problems with their health plans. We also provide statewide policy advocacy to resolve systemic health care issues impacting Californians. Translations: Spanish

Our Health Care Practice Tip this month details these changes and more. One common unlawful provision found in many hospitals’ fair pricing policies is a specific time period to apply, often set at 150 days. These deadlines violate the Hospital Fair Pricing Act, which allows patients to apply for charity care or discounted payments at any time, without time limit.  Meanwhile, hospitals may still commence collection activity after the statutory time period has passed. The Health Care Practice Tip explains this issue.

This resource from Justice In Aging provides an overview of durable medical equipment (DME) coverage in California, including common eligibility requirements, authorization rules, and advocacy strategies. Learn how Medi-Cal and other health coverage programs address medical equipment needs and how advocates can help consumers access medically necessary devices and supplies.

Justice in Aging’s new Advocate’s Guide on CalAIM provides updated information and highlights its impact on low-income older adults and people with disabilities. 

Medi-Cal covers four housing-related Community Supports for eligible individuals who are enrolled in a managed care plan. All plans currently offer all of these services. Read more about these services in this fact sheet from National Health Law Program.

Download the HCA FPL Chart 2026

Justice in Aging has produced these important fact sheets, on Open Enrollment for 2026 Coverage through Medicare & the Marketplace—Basics for Advocates and Coverage through Medicare & Covered California . These guides provide valuable information and resources every advocate should have to better understand the open enrollment process and various marketplace policies and rules.

Asset limits for Medi-Cal are changing in 2026. This fact sheet provides valuable information to help you understand how the asset limits are changing and if it will affect you. (Translations: Spanish)

Justice in Aging’s new resource, Dual Eligible Special Needs Plan (D-SNP) State Medicaid Agency Contract Toolkit, provides advocates and State Medicaid Agency policymakers with principles and corresponding template language to develop SMACs that are responsive to the needs of the dually eligible populations that they serve. Stakeholders are encouraged to use this tool to advance their priorities, utilizing and tailoring the components that are most appropriate for their state’s integrated environments.

Justice In Aging has produced a new fact sheet about the perils of cuts to Medicaid by the current administration. Download the fact sheet here.

The Health Consumer Alliance Quality of Care Chart provides valuable information on healthcare providers and facilities, helping consumers make informed decisions about their care. Find out how to use this resource effectively. Download it here.

As part of Justice in Aging's recently launched project to build capacity and educate advocates about dual populations in Dual Eligible Special Needs Plans or D-SNPs, this fact sheet provides an overview of California's D-SNP landscape, including the number and characteristics of people who are dually eligible in the state. To review other state's D-SNP profiles, please visit Justice in Aging's D-SNP Data Landscape page . The Health Consumer Alliance (HCA) services the Medicare Medi-Cal Ombudsman Program (MMOP) - which provides support to dual eligible members of Medi-Medi plans, DSNPs, and PACE programs, helping these consumers to overcome barriers to accessing needed health care benefits and services.

Mental Health Awareness Month is an important initiative that helps people understand how mental illness affects their lives. By promoting recognition, education, and open conversations, this month plays a crucial role in reducing the stigma associated with mental health conditions and creating a supportive environment for those in need. Make sure to use these mental health resources to fully understand your rights and access the support available to you.

• General Fact Sheet about Mental Health in California
• Mental Health Awareness for Older Adults - Use this fact sheet to discover helpful resources for older adults in California dealing with mental health challenges.
• Specialty Mental Health Services for Adults (SMHS) - This fact sheet provides information on the available supportive services for adults requiring greater mental health support in California.
• Specialty Mental Health Services for Youth - SMHS services are available to Youth, too! Use this fact sheet to learn about the additional mental health support California youth can receive.
• Mental Health Transition of Care Tools (TCTs) - This fact sheet contains general information about the transition of care tools, including how to access them and the support provided.
• Day Treatment Intensive & Day Rehabilitation Services - Use this fact sheet to explore the support provided by intensive and rehabilitation support services to eligible Californians needing deeper mental health support.

 

Justice in Aging provides a consolidated fact sheet on the basics of durable medical equipment and older adults for California advocates. (Apr. 2016)

Continuity of Care (“COC”) is critical to Medi-Cal beneficiaries in a variety of circumstances. There are a number of laws and policies that govern COC for Medi-Cal beneficiaries, depending on the situation. This fact sheet provides an overview of the laws and regulations that require COC for Medi-Cal beneficiaries.

This webinar was recorded on September 21, 2022. You can watch the recording by clicking the link above or here. The PowerPoint materials from this presentation are available by clicking here.

DHCS partnered with HCA to create a content-rich postcard that provides information and resources to support plan, provider, and stakeholder efforts to serve the needs of the LGBTQIA+ community and provide gender-affirming care. The postcard serves as a valuable resource for those seeking to improve the quality of care provided to this marginalized community and to ensure that they receive the best possible healthcare services.

Federal and state law and the Constitution ensure that enrollees in publicly-funded health care plans receive notice, grievance and appeal rights when they are denied access to medical services. Enrollees in Covered California plans have the right to a notice when their plan denies access to a service and have several avenues to contest the plan’s decision through a grievance or appeal. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not understand their right to appeal the plan’s decision. This fact sheet will describe the legal protections available to consumers in California and how to enforce these rights.