Health is serious, just ask Teresa Barrita, whose 62-year-old husband Rufino was on the verge of going blind and even risked death, due to a series of complications that stemmed from diabetes.
Rufino, owner of the La Victoria Taqueria in Redwood City, is a user of the new pilot program Cal MediConnect, which is available to seniors with low incomes who are, as in the case of Rufino, incapable of working and receive benefits from Medicare and Medi-Cal.
MediConnect is a product of the Affordable Health Care Act (aka “Obamacare”) and is part of a health program called Coordinated Care Initiative (CCI). According to its website Calduals.org, the Cal MediConnect program will combine the benefits of Medicare and Medi-Cal under one health plan.
Rufino suffers from diabetes and kidney problems, as well as heart and sight issues. The Barrita’s, who hail from Oaxaca, Mexico, have had to face many economic and family problems over the years due to the deteriorating health of Rufino.
“We have been through very difficult times,” Rufino said, his voice choked with emotion. “First it was the diabetes, then my heart, and I was retaining a lot of liquid. Then I lost sight completely, but right now it’s recovering.”
Currently, Rufino is receiving dialysis treatment, and his wife admits that if it were not for the medical benefits under Medicare and Medi-Cal, Rufino would not be alive.
Cal MediConnect is designed to more efficiently coordinate a single health care plan through the merging of these two programs. Over the years, low-income patients who receive benefits from both have had to grapple with these programs, since Medicare covers some things and Medi-Cal covers others.
People who received both Medicare and Medi-Cal were automatically registered in the Cal MediConnect program. Russell Hoyle, director of Marketing at Health Plan of San Mateo, said that from April until the first week of August, there had been 3,011 people enrolled in Cal MediConnect in San Mateo County, but that 2,736 of those were registered automatically.
Those who wish not to be in the program have the opportunity to opt out of Medicare benefits, but necessarily must choose a plan for Medi-Cal. People who decide to leave the program, or just register for a few months for a test run, can.
MediConnect Cal is not a definitive health program, as it’s in a test period of three years, and it doesn’t apply in every county in California. For now, it’s available in Alameda, Los Angeles, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara and Orange counties.
But Teresa said that she has yet to see a concrete benefit to switching to Cal MediConnect. The only thing that is better, she said, is not having to fill out as many forms. Rufino harbors many doubts, but admitted he has not called any agency to resolve his worries.
Charma Silvia has worked for years for the Health Plan of San Mateo (HPSM), a non-profit organization that provides medical coverage and a network of health care providers to residents of San Mateo County.
Silvia oversees CareAdvantage, which features the Cal MediConnect program. She said that in her 10-year experience, “Our Latin people hardly ask for help.”
She recommended that those who have doubts about Cal MediConnect in San Mateo County call (650) 616-2174.
She said that the benefits of this medical program are important, but many users remain unaware of them. For example beneficiaries are entitled to dental, vision and can even be taken by taxi to ask questions free of charge.
Christina Kahn of HICAP (Health Insurance Counseling & Advocacy Program) of San Mateo, a nonprofit that provides free counseling on Medicare to elderly, low-income or disabled people, said she is disappointed by the lack of interest on the part of people who are eligible to request more information about Cal MediConnect.
“We haven’t received [as] many calls as originally anticipated,” she said. “We were going to hire an extra person to take charge of any calls regarding Cal MediConnect, bilingual or Spanish-speaking people, but as we have not received many calls we have decided to cancel the recruitment plan.”
Kahn offered to have Spanish-speaking people to call her at (650) 627-9350.
* This report was made possible by a grant from New America Media sponsored by SCAN Foundation.