Elderly at Risk as Insurer Cuts Crucial Care Benefit

Health Net, a major Medi-Cal insurer, will end its assisted living benefits for about 3,500 members by the close of the year. This decision has created immense distress for families whose elderly relatives, many with dementia, depend on this coverage. Senior advocates warn of a potential crisis, with residents facing homelessness or being moved to more intensive, costly care settings.

Families report a severe lack of communication from Health Net, with customer service representatives often unaware of the program's termination. This confusion extends to providers, who are uncertain about contract end dates and payment obligations beyond October. State regulators state members are entitled to services until December 31 if clinically appropriate, but clarity remains elusive.

The insurer claims internal data suggests the program hasn't improved patient outcomes, citing cost concerns and changing program guidelines. However, advocates argue this move prioritizes cost savings over patient welfare, potentially leaving the most vulnerable without adequate support. The state's Department of Health Care Services is in communication with Health Net to ensure member protections and continuity of care.