Stanford 2019 Covered California FAQs for SHC
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Created: 02-11-2018
Updated: 02-11-2018
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Hospitals By County For Covered California Individual And Family Plans 2019
You can’t assume that all hospitals part of a larger network are all in-network with the same carrier if one is in-network. In Butte County, Blue Shield contracts with all the Enloe associated hospitals. But Anthem Blue Cross only contacts with Enloe Medical Center – Esplanade. The converse is also true. Blue Cross doesn’t typically contract with Sutter hospitals for their individual and family plans. However, in Amador County, Sutter Amador is an in-network hospital for Blue Cross.
Hidden Covered California Income Adjustment Feature
Once all the income is entered in the different sections of the Covered California application, the program has a little link titled, Click here if this looks wrong. That takes you to the Adjust Project Annual Income (PAI) window. You can then type in an amount that is higher or lower than the number calculated from the income sections. Unfortunately, once you have used the PAI feature, the Covered California system won’t alert you to the override if you need to update your income in the future.
Medi-Cal And Covered California Assistance And Terms
Caution! There are known data miss-match issues between SAWS and Covered California CalHEERS software. When a consumer is released from Medi-Cal it is necessary to scrub the application and look for missing or inaccurate data and conditions. The missing data could prevent the individual or family from getting the subsidy. It could be as simple as the application no longer indicating that the consumer will file taxes. This is simply fixed by checking Yes, the consumer will file taxes. Both Covered California and Medi-Cal are working to resolve this issue.
Medi_Cal Assistance Consumers Covered California FAQ_Final.pdf (929.13 KB)
Medi_Cal Assistance Consumers Covered California FAQ_Final.pdf (929.13 KB)
2019 Covered California Renewal And Enrollment Questions
If a consumer does not like their plan or rate, they must make changes to their account and actively renew their coverage by December 15th for a plan effective date of January 1, 2019. Changes to the account and plan selection between December 16th and January 15th will have an effective date of February 1, 2019.
Plans Covered California Blue Cross 2019.pdf (7.87 MB)
Trump Tax Reform May Cut Your Covered California Health Insurance Subsidy
For the family of a small business owner, the reduction of the MAGI because of the 20% deduction could drop any dependents under 18 years old into Medi-Cal. A family of four earning $70,000 makes all the household members eligible the tax credit subsidy through Covered California. If the family reduces their income by the 20% deduction, the new income is $56,000. That is below 266% of the federal poverty level for a family of four and all dependents 18 and younger are then deemed eligible for Medi-Cal.
Evolving Market Share Of Health Plans In Covered California
Anthem Blue Cross started out as carrier with the largest enrollments in 2014 and 2015. They dropped to 26% market share in 2016. They dropped again 2017 down to 19%. Part of the drop, from my perspective, was related to the cost of the health plan versus their EPO network. People didn’t see the value of the smaller network and no out of network coverage relative to other alternatives. Then in 2018 Blue Cross pulled out of most of California. They offered plans only in region 1 (Northern California), region 7 (Santa Clara County) and region 10 (Central Valley counties). This dropped their market share down to 5%.
