Kevin Knauss: Health, History, Travel, Insurance
There was no specific cause for the Molina action against me. The letter stated, “Molina has the right to terminate an appointment or revoke a Participating Producer’s authority to Solicit the Molina Marketplace products at any time.” Gosh, what had I ever done to Molina other than represent their products fairly when presenting their Covered California health plans to consumers?
Individuals and families in Medi-Cal HMO plans in 22 counties across the state may have to select a new health plan and doctors beginning January 2024. The Department of Health Care Services is transforming the Medi-Cal health plans with new requirements with the aim to improve health care quality. Implementation of the new contracts, along […]
Of all the Medicare plans, the Part D Prescription (PDP) plans are the most confusing. The confusion arises because Medicare allows the Part D plans to offer alternate plans that differ from the standard plan. The alternate plans must be as good as the standard plan for the average Medicare beneficiary. Cost Sharing of the […]
While the health insurance companies calculate your monthly health insurance rate based on your age and where you live, the Silver plans strongly influence your monthly health insurance premium through Covered California. Specifically, the subsidies through Covered California are based on making the second lowest cost Silver plan (SLCSP) affordable, regardless of what you plan […]
Silver 73, 87, and 94 health plans, available through Covered California based on household income, have no medical deductible. That does not mean you escape any patient responsibility for health care services subject to coinsurance. With the enhanced Silver plans, you go straight into the coinsurance percentage for inpatient hospitalization and skilled nursing facility stays because there is no medical deductible.
The orange percent column titles represent dollar amounts pertaining to the eligibility for Medi-Cal programs. For example, adults with incomes under 138 percent of the federal poverty level are eligible for Medi-Cal. There are specific columns for Medi-Cal for Pregnant Women, Medi-Cal for children under 19 years of age (266%), and Medi-Cal Access Program that corresponds with expanded children’s Medi-Cal in certain Bay Area counties (322%.)
The family did not understand what was going on. Why was their subsidy unilaterally changed by Covered California with no warning? They did not trust Covered California to get the numbers correct. I created a spreadsheet to see if the new subsidy and subsequent totals matched what they were eligible for at the estimated income.
Some people only learn they have been flipped into Medi-Cal when they are at their doctor’s office and the receptionist tells them their health insurance has been cancelled. What follows for many people is a nightmare scenario of trying to learn why their Covered California plan was terminated, who terminated it, why they are in Medi-Cal, and how to get of the Medi-Cal system.
Annual income. When entered on income section, Covered California will take the total amount and divide it by 12 and distribute an equal amount in each month. For example, you enter an annual income amount of $12,000 beginning in January. Each month through December will be allotted $1,000 to add to your monthly income and annual income totals.
The Medi-Cal annual redetermination paperwork can be confusing and complicated. It can be hard to reach a county Medi-Cal case worker to answer questions. The Department of Health Care Services maintains a webpage of local health enrollment navigators by county.
