Health Net to End Medi-Cal Assisted-Living Coverage, Threatening Thousands of Californians

Health Net, a major Medi-Cal insurer, will discontinue its assisted-living benefit for members after the current year, impacting an estimated 3,500 seniors, many with dementia. The program, part of the CalAIM initiative, traditionally covered the bulk of 24-hour care costs in board-and-care facilities, with residents paying room-and-board fees. Families such as Matt Johnstone’s have received little information, and some providers have already sent residents to emergency rooms.

State officials say members must be notified 30 days before termination and may stay covered through Dec. 31 if medically justified, but advocates argue consumer protections are insufficient. Health Net’s statement claims the benefit failed to lower emergency visits and that regulatory changes increased costs. Critics fear a surge of homeless seniors and pressure on nursing homes and hospitals as the transition unfolds.