PPT-Covered-California-Policy-and-Action-Items_October-8-2015
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Updated: 12-06-2017
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Job_Aid_-_Covered_California_Plan_Selection.pdf (1.84 MB)
112,000 People Will Lose Health Insurance Subsidies in California under Republican Bill
Covered California has estimated that 112,000 individuals will lose the health insurance subsidy under the proposed Republican budget reconciliation bill now under consideration in Congress. Language in the bill would prevent lawfully permanent residents in close to 40 categories from receiving the Advance Premium Tax Credit subsidy to lower health insurance premiums. Republican bill to […]
Home Health Care and Skilled Nursing California Health Plan Benefits
The summary of benefits of the health plans indicates 100 days of skilled nursing facility residency per member per benefit period. The benefit period begins when you enter the facility and ends when you leave or 60 days after you are discharged. This is where the descriptions get a little hazy. One interpretation is that you can have multiple 100-day stays during the year as long as there is a 60-day span between admissions.
Stanford Health Out-of-Network with Blue Shield of California
The Stanford Health Care hospitals and facilities contract with Blue Shield ended on June 28, 2024. Despite many months of good faith negotiations with Stanford Health, we have not been able to reach a reasonable agreement on reimbursement rates and contractual terms that are beneficial for both parties and keep care sustainably affordable for our members.
Paths to Health Insurance in California
The paths to health insurance in California: Medi-Cal, IFP, Employer, Medicare, overview.
Unexpected Costs of California Health Plans in 2024
Silver 73, 87, and 94 health plans, available through Covered California based on household income, have no medical deductible. That does not mean you escape any patient responsibility for health care services subject to coinsurance. With the enhanced Silver plans, you go straight into the coinsurance percentage for inpatient hospitalization and skilled nursing facility stays because there is no medical deductible.
Get Help with Medi-Cal Redetermination: Local Navigators in California
The Medi-Cal annual redetermination paperwork can be confusing and complicated. It can be hard to reach a county Medi-Cal case worker to answer questions. The Department of Health Care Services maintains a webpage of local health enrollment navigators by county.
No Gap or Short-Term Health Insurance in California
Loss of coverage is a Qualifying Life Event for a Special Enrollment Period into an individual and family plan. The problem for many people is the timing of the enrollment and the effective date of coverage. You must apply for an individual and family plan in the month prior to the effective date. Individual and family plans – in most instances – always become effective on the 1st of the month. There is no retroactive effective date offered.
Oscar California Health Plans Will Close With 2023
Even though Oscar was in California for 7 years, they never develop strong name or brand recognition for their health plans. I was always surprised when a client would curse one of the big health plans, then turn around and enroll with the same health plan. I suppose it was better to deal with the devil you know. Relative to the other carriers, Oscar offered a competitive EPO health plan product that worked as advertised.
