Marin Community Clinics’ Outreach & Enrollment Team
As a Certified Enrollment Counselor (CEC) and patient outreach specialist at Marin Community Clinics, Karla Bermejo-Coronel has seen first-hand how the right support at the right time can transform someone’s life. Handling a medical emergency can be challenging for anyone, but for low-income families working hard to make ends meet, navigating the complex process of determining what financial assistance may be available is often overwhelming.
“Earlier this year, I worked closely with a mother and father whose son was hospitalized with tuberculosis,” reports Bermejo-Coronel. “The family could
not afford the care their child urgently needed. They had no health insurance and, as newcomers to the U.S., had no idea what help might be available.
They simply did not know where to start.”
Fortunately, they were connected to Marin Community Clinics by an acquaintance. Bermejo-Coronel immediately stepped in and in short order enrolled them in Medi-Cal. The child’s health care was now covered and the parents could concentrate on his treatment and recovery.
In the past year, the team assisted 3,334 patients in enrolling or renewing their benefits.
“The system is so confusing – it’s like a maze,” explains Outreach and Enrollment Manager Armando Cerros. “There are so many options, and patients receive all kinds of mail from different insurance companies with different interests. Our job is to find the best solution for our patients and to guide them throughout the enrollment process. Every situation is different, and many of our patients are monolingual Spanish speakers, so having someone explain the benefits in their native language is invaluable.”
The CECs start with determining what insurance program individuals qualify for – it could be Medi-Cal or other insurance programs for low-income families such as Covered California, County Medical Services Program (CMSP), or Path to Health. Next, they gather the necessary documents and forms, help complete applications, and explain what to expect after enrollment. The work is not limited to new applicants for programs – they also assist patients with renewing benefits.
Stepping Up So No One Is Falling Through Cracks
Three years ago, the Federal Government instituted an emergency COVID-19 pandemic provision to ensure continuous Medi-Cal coverage for low-income families. By June 2023, 15 million Californians were enrolled statewide – a positive step towards increasing access to care.
In May 2023, the provision ended, which may result in families losing Medi-Cal benefits if they do not complete renewal applications. Medi-Cal offices review the information they have in a database. If they can confirm that the member remains eligible, they automatically renew benefits. If the Medi-Cal office cannot determine eligibility, the member needs to complete and submit renewal documentation. If the renewal packet is not submitted to Medi-Cal, benefits are terminated.