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.
Covered California
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
2024 Covered California Income Table Updated With New Medi-Cal Levels
I have created this income table that has the monthly income numbers for Medi-Cal eligibility next to the 2024 annual income amounts for the Covered California subsidies.The Medi-Cal income columns of the Covered California income table are 138% FPL for adults, 213% FPL for pregnant women, 266% FPL for children 18 years and younger, and 322% FPL for children in certain counties of California.
Review Your Covered California 1095-A For Errors
While some incorrect information may be corrected by calling the Covered California customer service line, other errors can only be fixed by filing a dispute form. The data that can be disputed are coverage start and stop dates, health insurance premiums, monthly subsidy forwarded to the health plan, missing family members, or household members who should not be in the tax family 1095-A.
Appealing A Covered California Loss of Subsidy Decision
Unfortunately, consumers should not have to go through this byzantine process of becoming private detectives to learn why they were denied enrollment or the subsidies. Covered California should spell out the specific reason either in a letter or on the phone. However, when all else fails you can file an appeal to kick the human process in gear to review your account.
Why You Lost Your Covered California Subsidy
In the second half of 2023 and continuing into 2024, we have seen some cases where the subsidy has mysterious disappeared. The estimated income is high enough for subsidies and nowhere near Medi-Cal range. The household member is enrolled in the selected health plan, but the subsidy has vanished.
When Increasing Your Covered California Income Estimate Creates an Ethical Dilemma
The ethical dilemma or conflict occurs because the household has agreed to report increased income streams, which will necessarily translate into higher health care costs. It is normal consumer behavior to minimize costs while maximizing benefits of any goods or services. The decision to report a higher income is clouded by issues such as the income is only an estimate and excess subsidy (Advance Premium Tax Credit) will be captured when the household files their federal income taxes.
Which Health Plans Include Your Doctors and Hospitals In Network
Whether you purchase your health insurance through Covered California or off-exchange direct from the carrier, you can use the Covered California Shop and Compare tool to search for doctors and hospitals. The Covered California provider search tool will display the network status of the doctors and hospital you select for all the different plans offered.
Which Metal Tier Health Plan Is Best For You?
Platinum plans can save money because they have health care and prescription drug costs half of the Gold and Silver plans. The Platinum plan only makes sense if you can reliably predict the health care and prescription drug utilization in the next year. For everyone else, without that crystal ball, a Silver or Bronze plan work better at containing health care costs.
Covered California Renewal Surprises: Loss of Subsidy, Medi-Cal
You will want to check your Covered California account. If the 2024 year is highlighted and it says Apply Now, you are not enrolled for 2024. You need to push the application through the process. All of the information is in the system, you just have to resubmit the application so you can select a plan for the new year.
Inland Empire Health Plan for Covered California
IEHP appears to have very competitive rates for the Bronze and Silver metal tier health plans. They are less competitive at the Gold and Platinum levels. IEHP is the primary Medi-Cal managed care plan for the 2 counties. With the end of public health emergency, many Medi-Cal beneficiaries may no longer be eligible and will be transitioned to Covered California private health plans with the health insurance subsidies.