Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
There are a variety of reasons why a household member needs to be removed from a family’s Covered California account. In some unfortunate instances a family member has died. Other times a young adult ages-off the plan or a spouse gains other coverage such as Medicare.
The Department of Health Care Services (DHCS) has developed a Medi-Cal household size flow chart. The DHCS Guide for Calculating MAGI Medi-Cal Individual Household Size was originally developed to help county eligibility workers ascertain the actual household size under the new Affordable Care Act (ACA) rules. The newly expanded Medi-Cal eligibility under the ACA revolves around on IRS definitions for tax dependents and non-filer rules. Because families can be so diverse and the rules regarding what constitutes a tax family so complicated, the flow chart for determining household size was created.
Covered California has finally been able to include family dental plan enrollment to consumers who have purchased a health plan through the exchange. The dental plans overall are pretty good but they come with some conditions that limit suitability for all families.
I wouldn’t have believed if I had not seen with my own eyes. For months the Covered California account of a client showed one of the household members enrolled in an Anthem Blue Cross plan. Then one day it disappeared. All Covered California can say is that they don’t see the member ever being enrolled. The client continues to pay for the phantom Anthem Blue Cross that Covered California says never existed. How was this enrollment information erased?
Covered California has quietly announced that they will not be offering individual and family dental plans through the exchange in 2015. The dumping of the family dental plan options comes after Covered California released a whole dental plan booklet of family dental plans in August of 2014. No reason was given as to why the dental plans will […]
A little known provision of health plans that also are designated as being a Health Savings Account (HSA) require a single member of a family to meet double the deductible amount of an individual before coinsurance is applied to health care services. Unlike traditional family plans where any one member of the household can transition […]
One would assume that the probabilities of a second Covered California enrollment nightmare would be less than being struck by lightning. But for one family, lightning has struck not once, but twice. Covered California and Blue Shield have teamed up to disenfranchise all but one family member because the mother delivered a healthy baby boy in […]
Covered California doesn’t have a monopoly on individual and family health plans in California. In addition to the carriers participating in the California exchange, Cigna is also offering health insurance outside of Covered California. Cigna is offering eleven different individual and family plan (IFP) options in California: seven Baseline Portfolio plans and four plans that mirror the Covered California standard metal tier levels for 2014. None of their plans are available through Covered California for the Advanced Premium Tax Credit.
One of the biggest questions regarding eligibility for premium assistance or discounts under the new Affordable Care Act is what type of income must the applicant count? The Covered California CalHEERS enrollment website will have a drop down menu to prompt households on the type of income they should be entering for eligibility.