Kevin Knauss: Health, History, Travel, Insurance
New for 2026 is an orange band on top of the table. This is the income range that California will provide additional subsidy to help lower health insurance premiums for low income families and individuals. The extra subsidy will be provided to incomes up to 165 percent of the federal poverty level. There is a new 165% column indicating the maximum annual income that the subsidy is eligible for.
All Sutter Health Plans are standard benefit designs. That means they mirror the plan structure offered by health plans offered through Covered California. They offer a Bronze 60, Silver 70, Gold 80 and Platinum HMO plans. There is no guessing if your Sutter physician or hospital is in-network with the health plan. This can be the issue for health plans that contract with Sutter.
Blue Shield also offers some plans not offered through Covered California. The Silver 2600 is a High Deductible Health Plan and is Health Savings Account compliant. After you have received $2,600 in health care services, remaining services and prescription medications are subject to 35 percent coinsurance. When the deductible plus coinsurance equals $7,350, you have met your maximum out-of-pocket annual amount.
If an individual is terminated from Medi-Cal because they failed to verify the work requirement, they are ineligible for the Advance Premium Tax Credit (APTC). The APTC is the subsidy through Covered California that reduces the monthly premiums of a private health plan.
If we assume the individual collects Social Security for 20 years, they will receive $128,709 less with the lower income. The individual saved $64,230 on self-employment taxes with the lower income of 25 percent. However, in this scenario, the reduced income costs the individual over $60,000 in Social Security benefits if they retire at their full retirement age.
For decades, Medi-Cal has verified the income for applicants and renewing beneficiaries using federal and state databases. The process known as the Income and Eligibility Verification System (IEVS). The California Department of Health Care Services has provided county Medi-Cal offices with a reminder of the IEVS process in an All County Welfare Directors Letter, 25-16. […]
Medicare allows alternate cost structure designs. These designs must be as good as the standard cost structure. One alternate structure only has drugs in tiers 3, 4, 5 subject to the pharmacy deductible. Generic drugs, tiers 1 and 2, are not subject to any deductible. The plan member goes straight into a set copayment or coinsurance for the prescriptions.
What I had noticed was the Prologue gained 4 to 6 miles of range over night. Sunday night the range showed 89 miles. Monday morning it was at 96 miles. The temperatures were over 100 degrees during the day, and the cooling fan would run when we stopped the Prologue. I’m assuming that once the battery cools down, it can provide more drive energy and that shows up as a few extra miles when the battery cools off overnight.
The Roadmap report generates the Maximum Social Security income scenario. We can also enter other age-based claiming scenarios that are detailed within the report. In the sample below, Mick was born in 1963, and his spouse Diana was born in 1977. Because Mick and Diana have children, the analysis concluded that Mick and Diana would receive the largest lifetime Social Security income benefit if Mick filed at age 63 and Diana claims Social Security when she turns 62 in 2039.
If the enhanced subsidy lapses, and Covered California must return to the pre-2021 subsidy curve, the consumer responsibility for health insurance increases. For the individual estimating $50,000, based on 2025 federal poverty level, they are still 343 percent FPL, but the consumer responsibility percentage increases from 7.08 percent to 9.78 percent*. (*Consumer Responsibility from IRS 2020 form 8962 instructions.)
