Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
The Silver 73 has lower cost-sharing than a Silver 70 and is unchanged for 2025. There are no medical or pharmacy deductibles. The maximum out-of-pocket is $6,100. The most significant change is that it will be available to any Covered California enrollee with income over 250 percent of the federal poverty level.
For eligible households with income over 250 percent FPL, only the Silver 73 plan will be offered, which is a better value than a Silver 70. At least for 2025, there will be no Silver 70 for qualifying households. The Silver 70 will still be offered to consumers who opt not to be considered for the Advance Premium Tax Credit subsidies based on household income.
Not all the below options may be available to you because some are contingent on your age, employment, or income. Those health insurance alternatives available to you are worth investigating and considering if they meet your budget or adequately address health care challenges you may be facing.
Covered California is using AI to expedite the verification process. Common documents are scanned by AI, determined valid, and then the account is updated that the requested verification has been provided. Of course, the quality of the image submitted to Covered California can play a large role in AI being able to recognize and verify it or fail the submission.
On May 2, 2024, I received an email, allegedly from Covered California, requesting I update my information for their store front program. The first clue that this was a phishing scam was that I never applied to the Covered California store front program.
Schedule 3 gathers additional credits and payments of the taxpayer. In this case, the taxpayer only has the $500 additional Premium Tax Credit to report and that goes on line 31 of form 1040.
Covered California has run a test using AI on several parts of the application process and found that the AI verification solution was successful 80 to 96 percent of the time in correctly identifying the documents submitted.
However, even though COBRA may be more expensive than a Covered California plan with the subsidies, there can be good reasons to opt into a COBRA plan. The COBRA plan will be the continuation of the employer plan, usually without any employer contribution to lower the monthly health insurance premiums.
The paths to health insurance in California: Medi-Cal, IFP, Employer, Medicare, overview.
Just because Joey’s 2023 final Modified Adjusted Gross Income was in the range for Medi-Cal, he will not lose his 2024 health plan and subsidies. The IRS does not report his income to Covered California to flip him into Medi-Cal. His 2024 subsidy is based on his good faith honest estimate of his 2024 income.
