Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
The BlueCard program allows members to receive some health care services outside of California. This is an important feature for individuals who routinely spend weeks or months outside of California on business. With the exception of emergency services, if an individual needed small health care service in another state, they were almost forced to buy two health plans; one for California and one for the other state.
If you indicate that your income in 2022 will begin on January 1, 2022, and you are applying in December, Covered California will determine you have NO income for December and are therefore eligible for Medi-Cal.
Most consumers would be surprised to learn that their health plans are being rated on how well their doctors treat them. Consumers don’t want their health plan involved in their health care decisions or interactions with their doctors. Consequently, some health plans are paying for the sins of some providers by being labeled with a low star rating.
There is a reasonable expectation that Bright HealthCare individual and family plans will fulfill all of their contractual obligations for paying claims and adhering to the member cost-sharing structure of the health plans. The weak spot for some health plans is the customer service department. An understaffed customer service unit can lead to long wait times on the phone or emails not being promptly returned. There can also be issues with prior authorization for medical procedures, durable medical equipment, and prescription medications.
The “California Premium Credit Program” is not an eligibility-based program. Starting plan year 2022, the $1 state premium credit will apply to both subsidized and unsubsidized Covered California QHP enrollees, including the catastrophic QHP enrollees but will exclude individuals in a dental-only plan.
The Sutter providers will mostly benefit counties where Blue Cross is expanding their coverage in the North Bay, East Bay, and Central Valley. A few counties in the Central Valley and most of Southern California will only be offered the Blue Cross HMO plans that do not include the Blue Card Program. Of course, Blue Cross offers additional EPO plans off-exchange, direct from Anthem, with a few extra plan designs that are not offered through Covered California.
It is counterintuitive, but for 2022, increased competition in the health insurance market for Contra Costa County will increase the premiums for Covered California members in the region. How is this possible? The subsidies are based on the Second Lowest Cost Silver Plan. Bright HealthCare, a new health plan, will offer Silver plans in 2022 […]
The new 2022 California Premium Credit Program covers the cost of said rule so that anyone who had a $1 monthly charge, will now have a $0 premium for their health insurance. Of course, the credit could not apply just to people were being charge only $1, everyone must receive the special $1 dollar bonus.
I’m sure many consumers will welcome the passive switch from a Bronze plan to a Silver 94 without having to pay anything more for the health insurance. An equal number of individuals will be perturbed that Covered California assumes they can unilaterally make decisions about a person’s health insurance with no consent from the effected member.
This same couple, based on 2021 rates, would have had a monthly subsidy of $788.47. If the couple were enrolled in the second lowest cost Silver 94 plan at $2 per month in 2021 – with the removal of the unemployment benefit – their new monthly premium will be $566 in 2022, that is a 28,000 percent increase. Plus, they will revert to a standard Silver 70 plan with higher cost-sharing.
