Kevin Knauss: Health, History, Travel, Insurance
If all you want is the lowest total cost (MOOP plus premiums), you would opt for a Bronze plan if the premium differential is greater than $229.17 per month between the Bronze 60 and Silver 73. If the premium differential is greater than $229.17 per month with the Silver 73, the total costs of MOOP and premium will be more than if you had a Bronze 60.
Covered California checks an IRS database of members to confirm they have filed a federal tax return. If you filed with an extension after April 15th, your federal tax filing status may not have been logged in the IRS system when Covered California checked the tax filing status. Consequently, many people who file their taxes with an extension are getting the Covered California letter stating they cannot confirm if the primary tax filer submitted a tax return. Another issue is if the primary tax filer for the last tax year is different than who is listed on the Covered California application.
Blue Shield of California, as well as other health plans, would like to break away from the large Pharmacy Benefit Managers and some of their distorted incentive and pricing structures. Unfortunately, the Pharmacy Benefit Managers perform many tasks involving price negation, handling the payments process from pharmacy to health plan, and managing the pharmacy network.
You need to request the report to make sure that the property in question is your home. Maybe they were looking at the wrong house. The images may show a condition that you have already addressed. When I received the risk assessment report, I knew the address was correct and it was my house.
Except for the initial funds from the federal government to establish Covered California back in 2011, they receive no federal or state money to fund their operations. While they do work under the Department of Managed Health Care, Covered California is an independent agency. They are funded by participation fees paid by the health plans.
When there is an error in a county Medi-Cal determination, it is nice if the beneficiary has an actual person to talk to. These people are known as case eligibility workers that work with most aspects of the eligibility determination process. Case eligibility workers seem to be going the way of most customer service departments for any business where access is governed by automated phone menus and chatbots.
Social Security recipients who have a Part D drug plan need to review their 2025 monthly premium rate. The changes to the Part D drug plans with a lower maximum out-of-pocket amount has forced many Part D plan sponsors to raise their monthly premiums. Rate increases of $30 to $50 per month is not uncommon.
We will see some health plans not be offered if there is a parallel marketplace with non-subsidized plans that have gaps and caps. Healthy people will migrate to the lower cost health plans leaving people who need health care services in the subsidized plans. This will cause the death spiral of the health plan as claims expenses increase with shrinking premium dollars.
The impacts of so many Medicare plans not paying an agent commission will suppress the number agents who are willing to assist enrollments for no compensation. In other words, some Medicare beneficiaries may have a tough time finding local agent help to evaluate their Medicare plan options.
However, individuals and families who had a qualifying event for a special enrollment period, and applied in October or November, are not in passive renewal status. You will need to push through the application for the next year. Select Apply Now from your home page to start the process.
