This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care Health Plans by type of enrollment by reporting period. Medi-Cal Managed Care program contracts for health care services through established networks of organized systems of care emphasizing primary and preventive care. Newly eligible Medi-Cal beneficiaries must choose a Managed Care health plan within 30 days of Medi-Cal enrollment, or they will be enrolled in a Managed Care health plan by default. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care County Organized Health System (COHS) Health Plans by reporting period. COHS is a Medi-Cal managed care health plan model that operates in 22 California counties. Each COHS is created by a county board of supervisors and governed by an independent commission. In COHS counties, a single plan serves all Medi-Cal beneficiaries enrolled in managed care. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care County Organized Health System (COHS) Health Plans by reporting period. COHS is a Medi-Cal managed care health plan model that operates in 22 California counties. Each COHS is created by a county board of supervisors and governed by an independent commission. In COHS counties, a single plan serves all Medi-Cal beneficiaries enrolled in managed care. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

This dataset includes the total number of newly eligible individuals by Insurance Affordability Program (IAP), by reporting period. IAPs include Medi-Cal, Covered California subsidized and unsubsidized Qualified Health Plans (QHP), and the Medi-Cal Access Program (MCAP). Covered California subsidized and unsubsidized QHP newly eligible data includes those who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes age and gender of newly Medi-Cal eligible individuals, by reporting period. The age and gender data is from the Medi-Cal Eligibility Data System (MEDS), and includes eligible individuals without prior Medi-Cal Eligibility. This dataset is part of the public reporting requirements set forth in California Welfare and Institutions Code 14102.5.

This dataset includes the number of individuals transitioned from Covered California Qualified Health Plan (QHP) eligibility to Medi-Cal enrollment commencing with the 2016 Quarter 4 Report. The individuals in this dataset represent Covered California clients, regardless of QHP enrollment status, who are in a Carry Forward Status (CFS) after reporting a change making them potentially eligible for MAGI Medi-Cal during a reporting period. The total number of individuals transitioned from Covered California includes Medi-Cal eligible individuals who did not have Medi-Cal eligibility in the month prior to the reporting period. This is a new dataset as a result of implementing the Covered California QHP Carry Forward Status indicator in release 16.9 and is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

This dataset includes the total number of newly eligible individuals by Insurance Affordability Program (IAP), by reporting period. IAPs include Medi-Cal, Covered California subsidized and unsubsidized Qualified Health Plans (QHP), and the Medi-Cal Access Program (MCAP). Covered California subsidized and unsubsidized QHP newly eligible data includes those who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.