Silver 73 Medi-Cal 2 Covered California
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Created: 08-07-2022
Updated: 08-07-2022
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Kevin Knauss: Health, History, Travel, Insurance

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Most of the links will take you to insurance agencies that can enroll you in a Covered California health plan. Unfortunately, some of the agents push indemnity and health care sharing ministry plans, not Covered California. Why do they do this? The commissions are higher for these plans. Once the consumer is enrolled in some of these plans, and subsequently want to terminate the coverage because they realize they did not enroll in real a real health plan, there is no support from the agency or the carrier.


Santa Barbara County sent a letter saying the couple did not qualify for Medi-Cal. They then received a letter from Covered California stating that they no longer qualified for any subsidy. When I accessed the couple’s Covered California account, all of their income information had been erased. When I looked at the transaction history on the Covered California account, Santa Barbara County Medi-Cal office had accessed the account and submitted changes.


The income section of the Covered California application is very date sensitive. If your application does not show any income in the month you are applying, you will be determined eligible for Medi-Cal. This is because Covered California screens for Medi-Cal eligibility based on your monthly income, regardless of how much income you earned prior to applying for Covered California.


When you receive an inheritance of money, that cash is an asset, no different than a savings account. The inheritance is not counted as monthly income. It is generally considered a one-time lump sum distribution. Consequently, an inheritance of money should not impact your MAGI Medi-Cal eligibility.


The minimum annual income in order to become eligible for the Covered California health insurance subsidies for a single adult is $18,756 for 2022. That is $980 higher than the minimum annual income for 2021, approximately a 6 percent increase. The minimum amount for 2 adults is $25,269 annual income. Estimated income amounts below 138 percent of the federal poverty level on the Covered California application will make the household eligible for Medi-Cal.

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You are first offered the chance to adjust the APTC subsidy from 100 percent to a lower percentage when you first enroll in a Covered California health plan. After the enrollment has been completed you must fish around in your account to find the APTC slider. The APTC slider allows you to reduce or dial back how much of the monthly APTC subsidy you are receiving from 100 percent down to 0.


PPO dental plans are more widely accepted than HMO plans. PPO plans will also reimburse you if you receive services from an out-of-network dentist. You will always minimize your out-of-pocket costs if you use an in-network dentist. PPO plans have higher monthly premiums because of the larger network of dentists and the out-of-network coverage provided. None of the dental plans will cover implants, tooth whitening, or adult orthodontics.


If you consider certified agents are an extension of the Covered California customer service staff, the different agent compensation models are like paying a different hourly wage based on the health plan enrollment. The varying compensation amounts introduces a certain level of bias. If you are paid $15 an hour for enrollments in health plan X and only $8 per hour for enrollments in health plan Y, which health plan would you favor?

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