There really is no mystery as to why the Covered California income chart doesn’t match the Medi-Cal federal poverty level income table. Covered California is working with two different programs. They must screen for MAGI Medi-Cal eligibility based on current monthly income and the latest federal poverty levels, and, they must also determine the Advance Premium Tax Credit subsidies following IRS guidelines that use the previous year’s federal poverty levels. And if you follow all of that, you are smarter than me!
Blue Shield of California is taking additional steps to remove barriers and help its members receive the health care they need during the coronavirus (COVID-19) pandemic, announcing today it will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020.
If your income increases, many people incorrectly assume they are no longer eligible for MAGI Medi-Cal. That is not the case. Medi-Cal is based on your monthly income, not necessarily your annual income. Just because you had an unexpected bump in your hours for one month, does not mean you are no longer eligible. Just report the change to Medi-Cal and let them make the determination. The same applies if you receive a one-time lump sum income amount. These types of events are not necessary counted against you.
The Social Security retirement income is really important. Your spouse may be on Medicare, and not seeking health insurance, but if they are receiving Social Security retirement benefits, that income, even though it may not be fully taxed, it must be included in the Modified Adjusted Gross Income. Many families have failed to include the Social Security retirement benefits in their income estimated and then found they earned too much money to qualify for the Premium Tax Credit subsidy and they had to pay it all back.
There are a couple of different reasons why health insurance companies may be reluctant to extend a grace period beyond the current 30-day date range. The first reason is California’s expanded Medi-Cal option. If an individual or family has a sudden decrease of income – below 138 percent of the federal poverty level for adults – and they do not have employer sponsored health insurance, they can immediately apply for Medi-Cal and get coverage at no cost.
This is a review of the responses to the Coronavirus Covid-19 health care issues from the websites of most of the individual and family plan carriers in California. Some websites detail the response and cost of Covid-19 health care issues better than other. They all seem to be covering Covid-19 testing at no cost. The cost of other health care services are subject to the plan benefits.
Effective Friday, March 20, Covered California opened the health insurance exchange to any eligible uninsured individuals who need health care coverage amid the COVID-19 national emergency. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through June 30.
You can call me anytime, or send me an email, and I will try to answer your questions. Sometimes this requires us to chat on the phone for a while, but I don’t have to visit your home, meet you at a closed café, and you don’t need to travel to my little home office. I’m open for business.
Covered California is expanding its dragnet to catch people who may not be entitled to the Advance Premium Tax Credit (APTC) subsidy. If you are eligible for Medicare, or have other minimum essential coverage (MEC), you are not eligible for the monthly APTC subsidy.
The extra $3,000 is clearly stated on the 1095-A. I have seen it. The question is, “What did Kaiser do with the extra $3,000 and how did they not figure out that they were receiving no consumer premium to attach to the monthly subsidy?”