Since the beginning of Covered California, many individuals and families have complained that some doctors refuse to accept health insurance purchased through Covered California. Most health insurance companies have stated that contracted network doctors can’t refuse to see Covered California members. However, Blue Shield of California seems to have changed their position on doctors refusing service. They are now stating, as of November 7th, that doctors can discriminate against individuals and families who have Covered California plans.
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Covered California Enrollment & Eligibility Support Documents
2024 Covered California Documents 2022 Guides for CoveredCA renewal and enrollment Archived Years Of Covered California Documents
Caution – Covered California 2017 Shop & Compare Tool is Broken
The new Covered California Shop and Compare Tool, launched in late September 2016, is broken. The comparison to tool to allow consumers to estimate their monthly subsidy and compare health plans has been giving erroneous results. The worst part is that Covered California has known about the issue and has failed to alert consumers or agents that the tool is giving bad results.
Did You Lose Your Covered California Subsidy? Blame it on Medi-Cal
Consumers logging into their Covered California accounts hoping to renewal their health insurance may find they have lost their subsidy. Instead of the reduced premium amount they are used to paying, Covered California displays that are not receiving the tax credit subsidy and must pay the full premium amount. A common denominator for consumers who have lost their subsidy is that they had been on Medi-Cal in 2016, but later in the year qualified for Covered California and the Advance Premium Tax Credits to lower their monthly health insurance bill. The transfer of critical application information from Medi-Cal to Covered California is missing, triggering a loss of the subsidy.
Covered California increases benefits, increases rates
Many Californians are facing sticker shock over the new health insurance premiums for their 2017 individual and family plans. Covered California and the insurance companies have pointed the finger at the elimination of the Affordable Care Acts reinsurance provision for the health plans. However, another contributing factor is the lower copayments on specific benefits Covered California has mandated in the new health plans. Consumers will be paying less for some out-of-pocket expenses. As the health plans must make up the difference for consumer’s lower cost-sharing, the rates must inevitably reflect this reality.
Covered California health insurance rate proposals may be incorrect
A really nice tool for agents and consumers to compare health insurance plan rates is the Shop and Compare Tool. Within this website you can also download a proposal that lists the available health plans by metal tier level for the household information entered. Unfortunately, I recently found that the proposal created may not always match the website results shown.
Covered California Plan Summaries
2025 Plan Summaries 2024 Health Plan Benefit Summary and Member Cost-Sharing 2023 Standard Benefit Design Metal Tier Health Plan Summary 2022 Standard Benefit Design Health Plan Summary FAQs for Covered California 2022 Individual & Families 2020 Metal Tier Health Plan Benefit Summary Health care services subject to the deductible of Bronze and Silver Plans Off-Exchange […]
Relationship between Covered California, IRS, & Health Insurance Tax Credits
While Covered California does a great job of marketing their services as an individual and family health insurance marketplace, the ultimate connection of reporting health insurance coverage to the IRS is not a central part of Covered California consumer education.
Covered California to allow family members to have different health plans
Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
Covered California to verify Qualifying Events for Special Enrollment Periods
Covered California has come under pointed criticism from the health insurance companies for their lack of verification of a consumer’s Qualifying Life Event (QLE) for a Special Enrollment Period (SEP). That will change as of August 1, 2016, when Covered California will start a program to randomly sample consumers who have enrolled in health plan outside of Open Enrollment under a QLE. Selected consumers will have to provide verification that they actually do have a QLE that makes them eligible to enroll outside of Open Enrollment such moving into California or the loss of minimum essential coverage like Medi-Cal or employer group coverage.