Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
If Obamacare is repealed by the Supreme Court, California will step into the vacuum. It may not be pretty and I am sure there will be a new tax on something, but California will figure a way to continue with the health insurance subsidies through Covered California.
California policy states that Disaster and Emergency assistance payments received from federal, state, or local government agencies is exempt from both Modified Adjusted Gross Income (MAGI) and non-MAGI Medi-Cal programs. Consequently, county Welfare Directors have been directed to disregard the LWA when making income eligibility determinations. However, for Covered California, the LWA money is counted as taxable income for eligibility and calculation of the monthly Advance Premium Tax Credit subsidy (federal) and the California Premium subsidy.
Covered California doesn’t administer or enroll you into a MAGI Medi-Cal health plan. Through the Covered California income section where you enter you monthly income, the Covered California application system determines if you or your dependents are eligible for MAGI Medi-Cal. If your income indicates you are eligible for MAGI Medi-Cal in the Covered California system, that information is pushed over to the Department of Health Care Services and your county social services office.
You cannot be enrolled in Medicare and a subsidized Covered California health plan. If you are eligible for Part A of Original Medicare, you are ineligible for the federal and state health insurance premium subsidies. If you don’t terminate your Covered California subsidized plan when your Medicare becomes active, you may have to repay all the subsidy amount you received for those months when Medicare became effective.
Covered California initially opened the health insurance exchange to any eligible uninsured individuals, who needed health care coverage amid the COVID-19 nation emergency, from March 20 to June 30. The new deadline means that anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can apply for coverage through July 31.
The failure on the part of Covered California is that they waited two weeks before generating a letter to the consumer explaining the situation. While the letter apologizes for the error, they never really spell out how or why it happened. It is sad the family had to learn from their health plan that their monthly bill was being adjusted.
Joe and Jan report the income change to Covered California in June so the new lower subsidy will take affect July 1. Much to their surprise, instead of a $850 subsidy, they only receive a $500 subsidy. Their health insurance premium will double! Why? Because they already used $7,200 of the new lower $10,200 subsidy at the higher income amount.
Covered California screens for Medi-Cal eligibility based on your monthly income, not annual income. Therefore, it is imperative, that when you are reporting a change to your income that the monthly income be accurate relative to published 138% of federal poverty level for adults and 266% for children.
Covered California has released a document explaining how the Coronavirus aid payments count as income for individuals and families. What could be a real issue for many mixed households (adults in Covered California and children on MAGI Medi-Cal) is that some of the extra unemployment benefits will be counted differently for the purposes of household income between the two agencies.
To allow for counties to prioritize processing of access to care issues, and concentrate staffing resources where needed during this public health crisis, the county shall stop processing annual renewals immediately and may exceed the timeliness standard for all administrative processing of Medi-Cal or Children’s Health Insurance Program (CHIP) redeterminations. The delay shall be effective for 90 days from the date of this MEDIL.
