Medi-Cal Managed Care Eligibility & Enrollment 101 Webinar
Understanding the basics of Medi-Cal eligibility and enrollment
Register now
April 30, 2025
1:30 – 3:00 p.m., Pacific Time
Overview
Who does the Medi-Cal program cover?
How does one become eligible for Medi-Cal?
How does an individual get enrolled in a Medi-Cal managed care plan?
The Medi-Cal program is critically important to nearly 15 million Californians — most of whom receive their health services through managed care. But despite its broad reach, not everyone is eligible for Medi-Cal. Because the program is jointly funded and administered by the federal and state governments, specific eligibility requirements must be met and verified before individuals can access and receive care. Such eligibility information, which is procured through the application and verification processes, provides health plans with vital information about the characteristics and needs of the members they serve.
Join us for this introductory webinar and learn more about Medi-Cal eligibility and enrollment, including who’s eligible, the different pathways to eligibility, how the enrollment process works, and how individuals are assigned to and enrolled in a managed care plan.
Who should attend:
Local health plan staff across all departments and levels who have an interest in understanding the basics of eligibility and enrollment or perform functions that are connected to or impacted by Medi-Cal eligibility and enrollment activities.
Agenda
Medi-Cal Eligibility — Context & Overview
- Joint federal and state-governed program with prescribed guidelines and requirements
- How federal requirements affect Medi-Cal eligibility
- Factors that drive eligibility
Who’s Eligible for Medi-Cal Coverage?
- Covered populations
- Modified Adjusted Gross Income (MAGI) and non-MAGI eligibility requirements
Pathways to Eligibility & Enrollment
- “All paths lead to coverage” approach to eligibility
- What happens once an application is filed
- Redetermination process for maintaining coverage
Enrolling in a Managed Care Plan
- How individuals enroll in a managed care plan
- How different plan models impact enrollment processes
- Issues around enrollment — changing health plans,
auto-assignments
How Plans Use Eligibility Information
- How eligibility information is used by health plans — PCP assignments, informing providers, etc.
Current Issues in Managed Care Enrollment
- Potential impacts from proposed federal policy changes
- Implications from the State budget — caseload, waiver flexibilities
Faculty
Thomas Pham
Vice President, Strategy
Inland Empire Health Plan
As the Vice President of Strategy, Thomas develops and executes IEHP’s Strategy System to advance the organization’s mission and achieve their bold 2030 Vision. He leads the creation and implementation of IEHP’s multi-year strategic plan and ensures the health of the entire strategy portfolio. He is responsible for the research of internal and external insights that help accelerate the organization’s success and help establish new strategic business opportunities. He is constantly seeking new ways to expand IEHP’s ability to serve the Inland Empire communities.
Thomas received a master’s degree in public health with an emphasis in health care administration from Loma Linda University and a bachelor’s degree from the University of California, Los Angeles.
Roshena Duree
Director of Self Sufficiency
County Welfare Directors Association of California
Roshena Duree joined CWDA as a Senior Self-Sufficiency Policy Analyst in June 2022 and was promoted to Deputy Director of Self Sufficiency in February 2023. In this role, Roshena serves as the policy lead for CWDA in the Self Sufficiency area.
Prior to joining CWDA, Roshena served as a Legislative Analyst and Associate Legislative Representative of health, human services, and homelessness for the California State Association of Counties (CSAC). Before joining CSAC she held the position of CalWORKs policy analyst at the California State Department of Social Services. Roshena began her career with Sacramento County Department of Human Assistance where she gained programmatic experience in CalWORKs, CalFresh, Medi-Cal and Child Care.
Roshena has a Bachelor of Arts in Sociology from the California State University, Sacramento.
Registration
This is an LHPC members-only program.
Fees* (per connection)
Members $50
Plan Registration^ $150
*Special registration pricing will be offered while health plan staff work remotely. Standard pricing will resume once staff return to work
on-site.
^ Select this option if plan staff will view the webinars communally on-site. Plans with multiple sites must register each site separately and identify whom at each site should receive the webinar access information upon registering. When registering, please enter unique email addresses for each additional site as the system may not allow duplicate logins.
Registration closes April 25 at 5:00 p.m.
Registration Confirmation: Registrants will receive two emails — a registration confirmation email and a separate email that contains access information for the webinar.
Participating in the Webinar: You will only need a computer with an updated web browser (Google Chrome, Microsoft Edge, Mozilla Firefox or Safari are recommended). Participants may opt to listen to the webinar via telephone or device.
Cancellation Policy: Cancellation notification must be submitted in writing to institute@lhpc.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged. Payment will be due for registered individuals that do not attend or participate in the event, and for which a cancellation notice is not received.