Medi-Cal

Posts related to California's Medi-Cal program, specifically MAGI based, income eligibility, enrollment, costs, children, Covered California.

Medi-Cal Takes Over Covered California

November 9, 2016 By Kevin Knauss 4 Comments

Several clients have contacted me regarding eligibility determination forms they have received from Medi-Cal, even though some or all of the family members have a Covered California plan with the tax credit subsidy. Even if the household information on the forms is wrong, Covered California consumers should supply the necessary information to their county Medi-Cal office or risk losing their private health plans altogether. Medi-Cal has effectively taken over the functions of Covered California if the family had been in Medi-Cal or if they still have children covered by Medi-Cal.

Did You Lose Your Covered California Subsidy? Blame it on Medi-Cal

October 25, 2016 By Kevin Knauss 19 Comments

Consumers logging into their Covered California accounts hoping to renewal their health insurance may find they have lost their subsidy. Instead of the reduced premium amount they are used to paying, Covered California displays that are not receiving the tax credit subsidy and must pay the full premium amount. A common denominator for consumers who have lost their subsidy is that they had been on Medi-Cal in 2016, but later in the year qualified for Covered California and the Advance Premium Tax Credits to lower their monthly health insurance bill. The transfer of critical application information from Medi-Cal to Covered California is missing, triggering a loss of the subsidy.

Orange County Medi-Cal corrupts Covered California consumer account

June 9, 2016 By Kevin Knauss Leave a Comment

One Orange County Medi-Cal eligibility worker not only made his necessary changes to the consumer’s account, he also corrupted some information within the Covered California enrollment system. Because Medi-Cal puts a soft pause on the consumer’s account when one of the household members is eligible for Medi-Cal, only the county Medi-Cal worker can correct the wrong mailing address they created and reverse the Covered California consumer’s negative declaration of interest in subsidized health insurance.

Medi-Cal Estate Recovery and IRS 1095-B confusion

May 27, 2016 By Kevin Knauss 8 Comments

The implementation of Obamacare requires it to be administered by a variety of federal, state, and local government bureaucracies. Many consumers have been caught in a swirl of seemingly conflicting and utterly confusing rules, advice, and government forms. This cauldron of Obamacare confusion is particularly acute among individuals over 55 years old who are subject to California’s Medi-Cal Estate Recovery program. The anxiety instilled in this population is compounded by conflicting IRS 1095 forms that seem to open the door to a large tax bill for the repayment of the premium subsidies they received during the year.

Non-Tax Filers will lose Covered California subsidy

May 6, 2016 By Kevin Knauss Leave a Comment

Covered California will strip the health insurance subsidy from consumers who have not filed their federal taxes beginning on May 16, 2016. Word of the non-tax filer ineligibility for the Obamacare tax credits was released in a summary of updates to the Covered California online application software known as CalHEERS. The release notes for the CalHEERS 16.4 update state that enhancements to the application will include a way for consumers to attest that they have filed their taxes.

Medi-Cal advocate smears health insurance agents

April 7, 2016 By Kevin Knauss Leave a Comment

Medi-Cal advocate Beth Capell smeared the reputation of all health insurance agents by insinuating that agents enroll Medi-Cal eligible children in private plans just for the commissions they derive from those enrollments. Ms. Capell is assuming, incorrectly, that all health agents put money above the best interest of their clients. It’s unclear where Ms. Capell’s animus towards health agents springs from when thousands of agents have assisted tens of thousands of families with enrollment in Covered California and Medi-Cal health plans.

County Medi-Cal Eligibility Questions and Answers

March 18, 2016 By Kevin Knauss 5 Comments

Two years after the launch of Covered California and expanded Medi-Cal, California’s Department of Health Care Services and each of California’s fifty-eight counties, that individually administer Medi-Cal managed health plans for eligible residents, are still grappling with numerous questions regarding eligibility, enrollment, and the integration with the Covered California application.

Covered California updates income reporting and former foster youth enrollment

March 13, 2016 By Kevin Knauss 3 Comments

On March 7 Covered California updated their online enrollment program with adjustments to how changes to income are calculated, plus new required fields for attestations from former foster youth. The Covered California CalHEERS program was also updated with new federal poverty level (FPL) incomes. A significant update will affect children in San Mateo, San Francisco, and Santa Clara counties where the higher household income of 322% of the FPL makes more children 18 years and younger in those counties eligible for Medi-Cal.

Medi-Cal set to snatch Bay Area kids from parent’s plans

March 5, 2016 By Kevin Knauss 2 Comments

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.

How much does my Medi-Cal plan cost?

March 4, 2016 By Kevin Knauss 4 Comments

With the expansion of Medicaid in California a large number individuals and families are now enrolled in a Medi-Cal health plan. The expanded Medi-Cal managed health care plans must cover all the same benefits as private health insurance purchased through Covered California. There is no cost to the consumer in terms of monthly premium, deductible, coinsurance or copayments. However, enrollment in these plans does cost something and I’m often asked how much these plans cost the tax payer.

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