Covered California sent out a notice that some children in the Bay Area will be deemed Medi-Cal eligible and will be taken off their parent’s health plan as of April 1, 2016. The expanded Medi-Cal kids’ option only applies to the Bay Area counties of San Mateo, San Francisco, and Santa Clara. Because these counties have a higher cost-of-living, they have higher income eligibility for the Medi-Cal kids program. Whereas most families have their children dropped in Medi-Cal if their Modified Adjusted Gross Income is below 266% of the federal poverty line (FPL), in these Bay Area counties children qualify for Medi-Cal with a household income of 322% of the FPL.
Covered California
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Comparing VSP vision insurance from Covered California
Covered California has struck a deal with VSP vision insurance plans to offer Covered California members vision insurance. The VSP vision insurance plan is only available to Covered California members. For the bare essentials of vision coverage, the VSP – Covered California plan is very competitive when compared to other insurance plans on the market. However, there are some eye wear options that don’t have specific copayment amounts and could cost the plan member more in the long run.
Medi-Cal continues to change Covered California consumer’s income
Medi-Cal county eligibility workers continue to tamper with the estimated income of Covered California consumers. The result of these unauthorized adjustments to household income is families continue to get dumped into Medi-Cal with no warning. Covered California continues to allow these anonymous bureaucrats to make unauthorized income adjustments with notification to the member. These nameless and faceless bureaucrats, making sometimes life and death decisions about a families’ health insurance, are the embodiment of government power run amok that scared so many opponents of Obamacare.
Original income and deduction data haunt Covered California applications
One of the most important parts of the Covered California health insurance application is making sure that the household monthly and annual income is correct. Some consumers may encounter problems with incorrect income information through no fault of their own. As Covered California has updated and improved their CalHEERS online application, older information may get orphaned. This is the only explanation for a consumer whose Covered California account showed a negative monthly income, but a positive annual income.
Calculating the value of the maximum out of pocket amount for health insurance
All individual and family health insurance plans include a maximum out-of-pocket amount that is the most an individual will pay on in-network health care services for a calendar year. This is particularly important for sole proprietors and self-employed people as one emergency room visit can easily top $20,000, and without health insurance, can imperil the person’s business. The value of the maximum out-of-pocket benefit can be measured and compared between different metal level health plan tiers and carriers as one guide in selecting a health plan.
Should you report your pregnancy to Covered California and Medi-Cal?
If a woman indicates on her Covered California individual and family plan account that she is pregnant, the application will be automatically screened for eligibility of certain Medi-Cal pregnancy programs. Some women have found that they are kicked off their private health plan with the premium assistance and relegated to the health care services only from Medi-Cal. This means they may not be able to see their regular OBGYN for pre-natal visits. However, you do not have to report your pregnancy to Covered California and risk being forced onto Medi-Cal.
Covered California supports a uniform agent commission structure
Over the course of two different letters to U.S. Department of Health and Human Services (HHS) Secretary Burwell, the Executive Director of Covered California, Peter Lee, outlined the benefit of Certified Insurance Agents to their enrollment activities and suggested there should a uniform commission structure for health insurance agents. Mr. Lee’s comments come at a critical time when many health insurance companies are reducing and even eliminating agent commissions.
Can Covered California Obamacare survive a Republican President?
Because of all the rhetoric from Republican Presidential contenders about repealing Obamacare I’ve fielded many calls from people wondering if Covered California will survive a Republican President. The fear instilled by the shrill comments of conservative politicians that hate the Affordable Care Act (ACA) is that families who rely on the premium assistance provided by Obamacare through Covered California will suddenly end if a Republican is elected President.
Covered California Take Action to Keep Premium Assistance notice
Some individuals and families who enrolled through Covered California have received a letter notifying them they are at risk of losing financial assistance in 2016. The letters being sent out include three reasons why a household might lose the premium assistance to lower their monthly health insurance bill. They are also frightening consumers who actually compiled with all the conditions they list in the letter.
Native American health plans misrepresented on Covered California
American Indians and Native Alaskans have access to special $0 cost share health plans that are available through Covered California. A recent enrollment by a member of a federally recognized Indian tribe was offered four different Anthem Blue Cross PPO $0 cost share plan where each one had a different premium rate. This is odd since regardless of the metal tier level of the $0 cost share American Indian-Native Alaskan (AI-NA) health plan, they all have the same exact benefits: zero dollar cost share for all services.