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.
Covered California
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
COBRA or Covered California, Which is Best?
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.
Paths to Health Insurance in California
The paths to health insurance in California: Medi-Cal, IFP, Employer, Medicare, overview.
When Your Tax Return Income Makes You Medi-Cal Eligible
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.
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.
