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Medi-Cal

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

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Should you report your pregnancy to Covered California and Medi-Cal?

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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.

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Medi-Cal Individual Household Size Flowchart

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The Department of Health Care Services (DHCS) has developed a Medi-Cal household size flow chart. The DHCS Guide for Calculating MAGI Medi-Cal Individual Household Size was originally developed to help county eligibility workers ascertain the actual household size under the new Affordable Care Act (ACA) rules. The newly expanded Medi-Cal eligibility under the ACA revolves around on IRS definitions for tax dependents and non-filer rules. Because families can be so diverse and the rules regarding what constitutes a tax family so complicated, the flow chart for determining household size was created.

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California health agents assist 429,365 Medi-Cal eligible individuals

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Covered California Certified Insurance Agents assisted 429,365 individuals for possible enrollment into the expanded ACA Medi-Cal health insurance from January 1, 2014 through July 31st, 2015. The Medi-Cal assistance enrollment figure comes from a Public Records Act Request that I submitted in early October of 2015 to Covered California. As the $58 compensation to agents for Medi-Cal enrollments ceased over the summer I felt it was important to learn the level of agent involvement with funneling Californians in Medi-Cal health plans.

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Accessing benefits under dual eligible special needs plans

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Anthem Blue Cross of California Medicare Advantage dual eligibility with Medi-Cal Special Needs Plans May 30, 2015 This guidance is generally applicable for all health insurance companies that offer Medicare Advantage Special Needs Plans for dual eligible beneficiaries. Dual Eligibles (Duals) are individuals who are entitled to benefits from both the federal Medicare and state-run […]

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How do I report an income change to Medi-Cal?

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For many individuals, families and their children that were award a Medi-Cal health plan based on their estimated Modified Adjusted Gross Income reported through the Covered California application, it can be a daunting task to report a change of income to Medi-Cal. As we have all learned, once Covered California hands of the enrollment to […]

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Appointing a Medi-Cal Authorized Representative

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Of the nearly 3 million Californian’s enrolled in Medi-Cal, Covered California estimates that approximately 2 million became newly eligible under the ACA expanded Medi-Cal rules. Many of the new Medi-Cal members are working families and individuals. They have little time to sit on hold with their local county social services department to correct Medi-Cal errors […]

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Five paths to California health insurance

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In California there are essentially five different paths to getting health insurance. Each of the different options have varying conditions and restrictions. Below is a summary of the five paths to California health insurance. There is also a short video you can watch titled California Paths to Health Insurance which also explains the five different […]

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Why are my children Medi-Cal? Annual vs. Monthly income

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Many parents are surprised to learn that their children are placed in Medi-Cal after completing the Covered California health insurance application. Medi-Cal eligibility is determined by the monthly household income, not the annual Modified Adjusted Gross Income. If the monthly household income is below 266% of the federal poverty level (FPL), but above 138% of […]

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New federal poverty line could knock Covered California families into Medi-Cal

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The federal Department of Health and Human Services has published the 2015 federal poverty line (FPL) which includes a modest increase over the 2014 FPL. The FPL is used by Marketplace exchanges like Covered California to determine when an individual or family is eligible for either Medicaid, Medi-Cal in California, or tax credits to purchase […]

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Should you sell assets to avoid Medicaid and get ACA tax credits?

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  Numerous individuals with income below the ACA threshold to receive tax credits must weigh the consequences of selling assets in order to be eligible for the tax credits to purchase a private plan through a Marketplace exchange like Covered California. The prospect of selling retirement assets early in order to qualify for affordable health […]

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