Kevin Knauss: Health, History, Travel, Insurance
Posts related to California's Medi-Cal program, specifically MAGI based, income eligibility, enrollment, costs, children, Covered California.
The federal government will consider only public benefits received directly by the person who is applying for the change in status, or if they’re listed as a beneficiary of the benefit. This means that your family members accessing public programs will not be considered as part of your public charge determination.
The Change Log Table shows that Sacramento County Medi-Cal returned the client’s household size to 2 and added the deceased spouse back into the household. The only notification the client received that Medi-Cal had meddled with her account was when she received a notice from Kaiser informing the client that her coverage had been terminated.
What is interesting is that these 2020 FPL income levels are higher than what Covered California posted in their program eligibility income chart at the start of the 2020 open enrollment period. Covered California listed the single adult Medi-Cal annual income level, 138% of FPL, at $17,237 and for a two-adult household at $23,226. The DHCS 2020 FPL income chart lists a higher amount of $17,609 for a single adult and $23,792 for two adults.
The Medi-Cal HMO plans are very similar to private health insurance plans. The plans have member ID cards, a provider network, and a drug formulary. One of the biggest complaints I hear is that the Medi-Cal HMO plans have few primary care providers and specialists that are accepting new patients. I also hear the same complaint from my clients in private health plans.
If Medi-Cal makes any changes to your account through Covered California, and you have family members who are in a private health plan through Covered California, you need to finalize the new plan. In the above scenario, an additional subsidy was applied to lower the health insurance premium.
ABLE account beneficiaries can contribute their own income or property to their ABLE account. A beneficiary may transfer countable property to their ABLE account to spenddown excess property.
When the Covered California system is in the renewal mode, changes to your household will affect enrollment and subsidies for 2020. If you need to make changes for 2019, you will want to go through the Report A Change function on the home page.
The requirement to repay cost of Medicaid and CHIP benefits pertains only to a sponsor who has signed a Form I-864 Affidavit of Support or a Form I-864A Contract. The state agency may not seek repayment from the sponsored immigrant.
Covered California has developed a reprieve from immediate reporting to SAWS in the event of an error on the application that triggers Medi-Cal eligibility. The one-day delay in reporting the eligibility results to Medi-Cal is outlined in the CalHEERS 19.7 release scheduled to be implement on July 22, 2019.
The brochure also outlines the rights and responsibilities of the Medi-Cal beneficiary. Eligibility determinations, either enrollment or termination, can be appealed. myMedi-Cal discusses the time periods for the appeals and the right to a State Fair Hearing.
