Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
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.
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.
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.
There was no specific cause for the Molina action against me. The letter stated, “Molina has the right to terminate an appointment or revoke a Participating Producer’s authority to Solicit the Molina Marketplace products at any time.” Gosh, what had I ever done to Molina other than represent their products fairly when presenting their Covered California health plans to consumers?
While the health insurance companies calculate your monthly health insurance rate based on your age and where you live, the Silver plans strongly influence your monthly health insurance premium through Covered California. Specifically, the subsidies through Covered California are based on making the second lowest cost Silver plan (SLCSP) affordable, regardless of what you plan […]
Silver 73, 87, and 94 health plans, available through Covered California based on household income, have no medical deductible. That does not mean you escape any patient responsibility for health care services subject to coinsurance. With the enhanced Silver plans, you go straight into the coinsurance percentage for inpatient hospitalization and skilled nursing facility stays because there is no medical deductible.
The orange percent column titles represent dollar amounts pertaining to the eligibility for Medi-Cal programs. For example, adults with incomes under 138 percent of the federal poverty level are eligible for Medi-Cal. There are specific columns for Medi-Cal for Pregnant Women, Medi-Cal for children under 19 years of age (266%), and Medi-Cal Access Program that corresponds with expanded children’s Medi-Cal in certain Bay Area counties (322%.)
The family did not understand what was going on. Why was their subsidy unilaterally changed by Covered California with no warning? They did not trust Covered California to get the numbers correct. I created a spreadsheet to see if the new subsidy and subsequent totals matched what they were eligible for at the estimated income.
Annual income. When entered on income section, Covered California will take the total amount and divide it by 12 and distribute an equal amount in each month. For example, you enter an annual income amount of $12,000 beginning in January. Each month through December will be allotted $1,000 to add to your monthly income and annual income totals.
There are a couple of different models of the deductible insurance plans. All of the designs require the individual to meet a deductible between $1,000 to $2,000. The plan’s deductible are health care expenses you must pay before the deductible insurance is triggered. Also with the models are two different maximum benefits of either $4,000 or $6,000. In other words, the plan will cover either $4,000 or $6,000 in health care expenses in a calendar year.
