Kevin Knauss: Health, History, Travel, Insurance
If you get a confusing letter from Covered California, immediately call your agent or a customer service representative. Not responding to little questions from Covered California can cause the loss of health insurance as one family found out the hard way.
Overview of how the Federal Poverty Level income amounts relate to eligibility for Medi-Cal and Covered California.
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 family continued to wait, not paying any of the invoices they received because they figured that Covered California was working to resolve the issue. The health insurance plan was terminated by the health plan for lack of payment. If the consumer does not pay the all the premiums after 90 days, the consumer loses the right to make all the back-premium payments and reinstate the health plan. This is what happened to the family.
Prior to the 19.4 update, I could always review the documents and correspondence for an account as an agent. This information was vital to see when letters were sent out and if they were returned to Covered California. It also showed which documents we had uploaded for verification purposes like income or residency. As of Monday, May 20, this section has vanished.
Until Covered California fixed the glitch, all women who reported they were pregnant were channeled into the Full Scope Medi-Cal for Pregnant Women program and had their Covered California health plans automatically terminated. This was a nightmare for many families as it completely disrupted their plans for the OBGYN they wanted to see and where they wanted to have their baby delivered.
The 1095-A is almost as important as filing taxes. Even if you did not owe taxes in 2017, but still received the APTC, you have to file a tax return. Covered California has been notified by the IRS if a current household, receiving the subsidy, has not filed a 2017 tax return. Covered California is sending out letters to consumers that their current monthly APTC subsidy will be terminated if they do not resolve the issue.
