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Covered California Renewal Surprises: Loss of Subsidy, Medi-Cal

Kevin Knauss

The Open Enrollment Period is a tricky time for Covered California and the health plans. You will want to check your Covered California account to make sure everything is in order and avoid surprises. The surprises can range from no enrollment for 2024, loss of subsidies, and household members determined eligible for Medi-Cal.

Check you Covered California before the New Year to avoid surprises to your health insurance.

For individuals and families who enrolled in Covered California for an effective date of November or December, those accounts were not automatically renewed for the next year. In other words. Those families have no health plan for 2024. It appears that Covered California only automatically renews accounts that were active in September or earlier.

Individuals and families who enroll into Covered California for November and December will not be automatically renewed for 2024. The consumer needs to push through the health insurance enrollment for the next year.

You will want to check your Covered California account. If the 2024 year is highlighted and it says Apply Now, you are not enrolled for 2024. You need to push the application through the process. All of the information is in the system, you just have to resubmit the application so you can select a plan for the new year.

If your account was not renewed, the Covered California home page will show 2024 and Apply Now, even though you are enrolled for 2023.

Oddly, there are times when Covered California completely erases the health insurance subsidies for the next year. In this is example, the individual received subsidies for 2023 when he enrolled in October. Upon renewing the application for 2024, the subsidies were zeroed out.

The consumer received a subsidy for his enrollment in October 2023. Covered California removed the subsidy for 2024 because they were notified he had Medi-Cal coverage.

When we looked at the Eligibility Results, it noted that Financial Help (the subsidies) had been discontinued. Additionally, we learned that Covered California had received information that the consumer also had Medi-Cal coverage. Because he had minimum essential coverage through Medi-Cal, Covered California removed the monthly subsidies. He then had to get on the phone and learn what county had him in the Medi-Cal database and have it cleared to regain the subsidies.

On the eligibility results page, the details section will indicate why Covered California zeroed out the subsidies for your account.

A very typical surprise is when the children of a family are determined eligible for Medi-Cal. Usually this happens because of an issue with the monthly income. Perhaps an income entry ended and the new job was not properly entered onto the Covered California application. When the account was renewed, BOOM, the monthly income is too low and the children are in Medi-Cal.

Typically, it is an income error that reduces the monthly income for the next year and trips the children into Medi-Cal.
Always check your income section. If an income has ended and there is no replacement income, the monthly household income may be too low and Medi-Cal eligibility is triggered.

The only way to clear the Medi-Cal surprise is to call the county and prove you earn too much for your children to be on Medi-Cal. Those phone calls can last hours. The prospect of having to be on hold with the county Medi-Cal office should be enough motivation to check your Covered California account before the start of the New Year.

Avoid Covered California Surprises. Check your Covered California account before the New Year.
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