Regardless of the error, Medi-Cal updates the Covered California income section denying the non-Medicare spouse their private health insurance with the subsidy. The spouse is determined Medi-Cal eligible and their health plan is terminated.
Covered California
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Social Security Increases and Covered California Income Updates
Because of the Social Security Fairness Act, Jan will receive a monthly benefit of $1,000. Unfortunately, Jan doesn’t receive the one-time lump payment for 2025 until December, too late to amend their Covered California income estimate. Jan and David must reconcile the higher annual income on their federal income tax return.
Fire and Earthquake Natural Disaster Special Enrollment Period
Individuals and families have a 60-day window to enroll in Covered California, or if they are current consumers, change their health plans. If someone has lost their health insurance because of the Palisades Fire, they can enroll in Covered California, outside of Open Enrollment, by March 8. If the individual or family wants the health insurance to start March 1st, they need to enroll by February 28th.
What is the Better Value, Bronze 60 or Silver 73?
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.
Confirming You Filed Your Taxes for Covered California
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.
Will Covered California Survive Trump?
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.
Will the ACA Survive Trump’s Second Term as President?
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.
Special Enrollment Covered California Renewal Issue
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.
Home Health Care and Skilled Nursing California Health Plan Benefits
The summary of benefits of the health plans indicates 100 days of skilled nursing facility residency per member per benefit period. The benefit period begins when you enter the facility and ends when you leave or 60 days after you are discharged. This is where the descriptions get a little hazy. One interpretation is that you can have multiple 100-day stays during the year as long as there is a 60-day span between admissions.
How Rate Increases Lower Covered California Health Insurance
There are times when some regions get a huge windfall of subsidies. In Region 9, Valley Health Plan left the region. This dropped the expensive Blue Cross EPO into the SLCSP slot. This resulted in a 57 percent increase of the SLCSP rate in 2025 from Blue Shield HMO that was the SLCSP in 2024.
