Asthma is a significant public health issue, particularly among Medi-Cal members.
Black Californians are five times more likely to visit the emergency department and four times more likely to be hospitalized for asthma than White Californians, and more than 2 million Latinos in the state live with asthma.
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Medi-Cal offers new services to help members manage and reduce asthma triggers where they often experience them most, in their own home.
Asthma Remediation as Part of Community Supports
Asthma Remediation is one of the 14 optional Community Supports Medi-Cal managed care plans can offer. Community Supports are new and improved services to help Medi-Cal members get well-rounded, whole person care that goes beyond the doctor’s office or hospital.
This program provides home modifications and interventions to manage asthma symptoms, reduce emergency room visits, and improve the quality of life for eligible members.
Transform Your Home to Manage Asthma
Medi-Cal’s Asthma Remediation service covers essential modifications to ensure your home is a safe haven, including:
- Allergen-impermeable mattress and pillow covers to block dust mites.
- High-efficiency particulate air (HEPA) filtered vacuums to effectively remove allergens.
- Integrated Pest Management services to eliminate pests that can trigger asthma.
- De-humidifiers to control moisture levels and prevent mold growth.
- Mechanical air filters to keep indoor air clean.
- Asthma-friendly cleaning products and supplies that contain minimal chemical irritants.
- Minor mold removal and remediation services to ensure mold-free living spaces.
- Other moisture-controlling interventions to maintain a dry and healthy environment.
- Ventilation improvements to enhance air circulation.
- Other medically appropriate and cost-effective interventions identified by your health care provider.
How to Access Asthma Remediation Services
To qualify for these services, members must meet certain criteria:
- Eligibility Criteria: The member must have poorly controlled asthma, indicated by recent emergency department visits, hospitalizations, frequent urgent care visits, or a score of 19 or lower on the Asthma Control Test.
- Home Evaluation: An assessment of the member’s home must be conducted through the Asthma Preventive Services benefit to determine needs and the suitability of any requested remediation(s).
- Health Provider’s Order: A licensed health care provider must request the necessary remediations based on member needs.
Members can reach out to their managed care health plan or speak with their doctor to find out more information about available Asthma Remediation services.
Comprehensive Support and Education
Asthma Remediation goes beyond home modifications. The program also empowers members with knowledge, providing information about how to identify and mitigate environmental triggers commonly found in and around homes, including allergens and irritants. Members will learn how to:
- Use dust-proof mattresses and pillow covers.
- Properly use HEPA vacuums and asthma-friendly cleaning products.
- Implement moisture control measures and improve ventilation.
- Conduct minor home repairs, such as sealing cracks to prevent pest entry.
Financial and Coverage Details
Medi-Cal covers the costs of asthma remediations up to a lifetime maximum of $7,500 per member. This amount can be increased if significant changes in condition require additional modifications to ensure the member’s health, well-being, and safety, or to help the member achieve greater independence at home and avoid institutionalization or hospitalization. All interventions must adhere to state and local building codes and must be performed by licensed contractors to ensure quality and safety.
Enhancing the Member’s Quality of Life
Medi-Cal’s Asthma Remediation services are designed to supplement and enhance the care members already receive, providing comprehensive support to address the root causes of asthma triggers in the home.
With robust support, education, and financial coverage, Medi-Cal helps ensure that members receive the necessary modifications to live healthier lives.
Get Started Today
If you or a loved one is struggling with poorly controlled asthma, don’t wait to act. Contact your health care provider to discuss your eligibility for Medi-Cal Asthma Remediation services and start your journey toward a safer, healthier home.
For more information, call the state’s Medi-Cal Managed Care Office of the Ombudsman at (888) 452-8609 or email MMCDOmbudsmanOffice@dhcs.ca.gov.
In Riverside County and San Bernardino County, Medi-Cal recipients can contact:
* Inland Empire Health Plan: 800-440-4347
* Kaiser Permanente: 855-839-7613
* Molina HealthCare of California Partner Plan, Inc.: 888-665-4621
Take the first step today to transform your home into a healthier, safer environment.