For a single adult applying through Covered California, the monthly income must be greater than 138% of the Federal Poverty Level ($1,397 monthly, $16,754 annually) in order to qualify for private health insurance with the premium tax credit subsidy. If the individual or household is below 138% of the FPL, they will be deemed eligible for Medi-Cal.
One of my clients received a letter from Covered California notifying her that her monthly premium would jump from $63.64 to $993.45 per month. The letter casually stated that the premium increase was 147.2%. The client is a household of two people one eligible for Covered California and the spouse is on Medicare. When I went through the renewal procedure on the updated Covered California website, I had to re-confirm that the spouse was on Medicare. The final eligibility results were that the Medicare spouse could select a plan at the full premium amount while the primary applicant could select a plan with the monthly subsidies.
A review of health insurance rates in Northern and Southern California shows rates for young adults will increase between 30% to over 40%. Instead of the 6% to 16% increase in rates for adults only, families could experience a 20% increase in health insurance rates in 2018.
Previously, the CalHEERS application collected the same information for all consumers in a systematic, if non-user friendly process. The navigation and messaging provided in CalHEERS lead to frustration for many users. Also, there were some federal regulations that were not being met regarding the collection of information for some groups, such as veterans.
Now, the interface is easier to read and questions are user-friendly. Since not all questions are needed for all consumers, the application is now “dynamic” meaning questions that do not apply to a user are not displayed. This results in fewer questions and additional time savings for everyone.