NAMI Santa Cruz County
Help Line: (831) 427-8020
Línea de ayuda en español: (831) 205-7074
Administrative Office: (831) 824-0406
  • Home
    • About Us
    • Board Members
    • Staff Members
    • Contact Us
    • Job Opportunities at NAMI!
  • En Español
    • Grupo de Apoyo Para Familias
    • Grupo de Apoyo Conexion
    • De Familia a Familia
    • Persona a Persona
    • Bases
    • Serie de Eventos en Abril: Colaboración Comunitaria
    • Junta Comunitaria Virtual para Familias
    • NAMI Nacional
    • Recursos En Espanol
    • Zoom
  • Groups
    • NAMI Family Support Groups >
      • Family Support Group (18+)
      • Parents/Caregivers of Youth (11-17) Support Group
      • Young Adult (18-26) Family Support Group
      • Groups.io
    • NAMI Peer Connection
    • Zoom Troubleshooting
    • Zoom FAQs
    • Other Groups
  • Classes
    • Peer-to-Peer
    • Family-to-Family
    • NAMI Basics
    • Provider Education
    • Online Courses
  • Crisis
  • School Presentations
    • Student Resources
    • Request a Presentation
  • Resources
    • (NEW!) Jail Guide
    • Youth Resources
    • Public Services
    • Veterans
    • Therapists and Psychiatrists
    • Increased Treatment or Support
    • Housing
    • Community Engagement
    • Work
    • SSI/SSDI Benefits
    • Legal
    • Respite Care
    • Other Resources
    • Family Information Form
  • Events
    • Speaker Meetings
    • April Community Collaboration Event Series
    • Lunch and Learn
  • Donate
  • Learn
    • Accomplishments 2020-2021
    • What to do when your family member has been arrested
    • MediCal and Health Reform
    • Radio Show: State of Mind
    • NAMI SCC Facebook
    • NAMI Ask the Doctor (outside link)
    • Maintaining a Healthy Relationship (outside link)
    • Insurance Parity
  • COVID-19 Resources
    • General Information
    • Mental Health Support
    • Financial Assistance
    • Volunteer Opportunities
    • Legal
  • Get Involved

MediCal and Health Reform

On March 29, 2016, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to strengthen access to mental health and substance use services for people with Medicaid or Children’s Health Insurance Program (CHIP) aligning with protections already required of health plans in the commercial market. The Mental Health Parity and Addiction Equity Act of 2008 generally requires that health insurance plans treat mental health and substance use disorder benefits on equal footing as medical and surgical benefits.

In order to support states, providers, and consumers CMS has created a mailbox so that stakeholders may send questions regarding the Medicaid and CHIP final rule for mental health parity. Technical assistance will begin this fall and continue through 2018, and questions can be submitted to the mailbox at any time.  Please submit all questions/concerns to parity@cms.hhs.gov

NAMI parents, clients and family who feel they are not getting fair insurance treatment in terms of parity can find information at: https://www.cms.gov

Other Health Reform Facts

  • 2013 Preventive health services were added to Medicare and the donut hole reduced for the pharmacy benefit.
  • Parity laws are going into place for mental health and substance use disorders which means that all health plans will need to have a core package of services.   This is very important for families with private insurance.   Also the co-pays and deductibles must be the same as for physical healthcare.   Advocacy on the core benefit issue is important to be sure that individuals in need can get psychiatric care, medications, lab work, therapy, case management, and other recovery services.   We are currently waiting for those decisions to be made.
  • Insurance Exchange:  For those making more than 133% of federal poverty, new subsidized insurance is available including through the Central CA Alliance to cover similar services.     
  • Individual mandate:  All individuals will need to get coverage through MediCal, a subsidized plan, their employer, or through the private insurance market.   This began January 2014.   There will no longer be discrimination against those with pre-existing conditions for adults and older adults.
  • Health Insurance Premium and cost sharing subsidies are available through the exchanges.
  • No limits on coverage: January 2014.   Most plans had a life time cap of $1 million dollars.  These caps are eliminated.
  • All Health Plans must have wellness programs and preventive care.  
For more information check:
www.kaiserfamilyfoundation.org
www.accesshealth.org
www.DHCS.ca.gov
www.NAMI.org
www.CHCF.org
www.cms.gov

DHCS Working Disabled Program
A critical Work Incentive program to encourage and help people with disabilities work while having access to healthcare such as MediCal. The 250% Working Disabled Program (250% WDP) allows certain working disabled individuals to become eligible for Medi-Cal by paying low monthly premiums based on net countable income. Program enrollment is done at the local county welfare department.

CLICK HERE TO LEARN MORE
info@namiscc.org  • Help Line (831) 427-8020 • Office Line (831) 824-0406 • NAMI SCC, 542 Ocean St, Suite F, Santa Cruz , CA 95060
  • NAMI Santa Cruz County Facebook
  • NAMI Santa Cruz Instagram
  • Mental Health Client Action Network (MHCAN)
  • Santa Cruz County Health
  • NAMI California website
  • NAMI National website
NAMI Santa Cruz County is a 501(c)(3) nonprofit Donations are tax-deductible
Federal Tax ID # 77-0002878
Picture
The information available on and through the namiscc.org website is presented in summary form as a supplement to, and NOT a substitute for, the knowledge, skill, and judgment of qualified psychiatrists, psychologists, physicians and health care professionals. The information on NAMISCC.org has been obtained from sources believed to be accurate and reliable. However, NAMI makes no warranty as to the accuracy, reliability or completeness of this information. We have NOT vetted the Providers.  

Information accessed on and through NAMISCC.org is provided "AS IS" and without warranty, express or implied, including, but not limited to, any implied warranty of merchantability or of fitness for a particular purpose.