Kevin Knauss: Health, History, Travel, Insurance
There are a variety of reasons why a household member needs to be removed from a family’s Covered California account. In some unfortunate instances a family member has died. Other times a young adult ages-off the plan or a spouse gains other coverage such as Medicare.
On March 7 Covered California updated their online enrollment program with adjustments to how changes to income are calculated, plus new required fields for attestations from former foster youth. The Covered California CalHEERS program was also updated with new federal poverty level (FPL) incomes. A significant update will affect children in San Mateo, San Francisco, and Santa Clara counties where the higher household income of 322% of the FPL makes more children 18 years and younger in those counties eligible for Medi-Cal.
Covered California has released a form for consumers to attest that they are not in jail or incarcerated. Consumers who purchase health insurance are ineligible for the premium assistance tax credits if they are in jail or incarcerated in a prison. It’s unclear how Covered California knows if an individual is in jail or why, if they have been released, they aren’t alerted that a person has been released from custody.
Covered California has struck a deal with VSP vision insurance plans to offer Covered California members vision insurance. The VSP vision insurance plan is only available to Covered California members. For the bare essentials of vision coverage, the VSP – Covered California plan is very competitive when compared to other insurance plans on the market. However, there are some eye wear options that don’t have specific copayment amounts and could cost the plan member more in the long run.
Medi-Cal county eligibility workers continue to tamper with the estimated income of Covered California consumers. The result of these unauthorized adjustments to household income is families continue to get dumped into Medi-Cal with no warning. Covered California continues to allow these anonymous bureaucrats to make unauthorized income adjustments with notification to the member. These nameless and faceless bureaucrats, making sometimes life and death decisions about a families’ health insurance, are the embodiment of government power run amok that scared so many opponents of Obamacare.
One of the most important parts of the Covered California health insurance application is making sure that the household monthly and annual income is correct. Some consumers may encounter problems with incorrect income information through no fault of their own. As Covered California has updated and improved their CalHEERS online application, older information may get orphaned. This is the only explanation for a consumer whose Covered California account showed a negative monthly income, but a positive annual income.
If a woman indicates on her Covered California individual and family plan account that she is pregnant, the application will be automatically screened for eligibility of certain Medi-Cal pregnancy programs. Some women have found that they are kicked off their private health plan with the premium assistance and relegated to the health care services only from Medi-Cal. This means they may not be able to see their regular OBGYN for pre-natal visits. However, you do not have to report your pregnancy to Covered California and risk being forced onto Medi-Cal.
Over the course of two different letters to U.S. Department of Health and Human Services (HHS) Secretary Burwell, the Executive Director of Covered California, Peter Lee, outlined the benefit of Certified Insurance Agents to their enrollment activities and suggested there should a uniform commission structure for health insurance agents. Mr. Lee’s comments come at a critical time when many health insurance companies are reducing and even eliminating agent commissions.
Because of all the rhetoric from Republican Presidential contenders about repealing Obamacare I’ve fielded many calls from people wondering if Covered California will survive a Republican President. The fear instilled by the shrill comments of conservative politicians that hate the Affordable Care Act (ACA) is that families who rely on the premium assistance provided by Obamacare through Covered California will suddenly end if a Republican is elected President.
Some individuals and families who enrolled through Covered California have received a letter notifying them they are at risk of losing financial assistance in 2016. The letters being sent out include three reasons why a household might lose the premium assistance to lower their monthly health insurance bill. They are also frightening consumers who actually compiled with all the conditions they list in the letter.
