Kevin Knauss: Health, History, Travel, Insurance
Posts related to the Covered California application, consumer account, estimating income, household size, monthly subsidies, health plans, Medi-Cal, and terminations.
I have always felt uncomfortable asking the Covered California applicant if they or anyone in the household is pregnant. Basically, it is none of my business. It is additionally awkward asking a mother or father if their adult daughter is pregnant. Now that reproductive health care is under assault in our country, I’ve become even more sensitive to asking the question.
Of course, 1.7 million people is a sizeable number of individuals and most of them are receiving a subsidy to reduce their monthly health insurance premiums. Covered California provided a breakdown of the enrollment by region. There are 19 different rating regions in California, some of which encompass more than one county. Covered California also provided the average health insurance premium rate change for 2023 for each region.
Your children could be flipped into Medi-Cal if you return to Covered California without having properly terminated Medi-Cal earlier. On numerous occasions, children were flipped from Covered California to Medi-Cal, even if the stated estimated income was high enough to make everyone eligible for the subsidies.
The Public Health Emergency (PHE) conditions state that no one will be terminated from Medi-Cal unless they move out of state. Of course, individuals can report a change to their situation, such as gaining employer sponsored health insurance, and seek a termination from Medi-Cal.
Consumers transitioned to Covered California do not have to keep the lowest cost Silver plan they have been enrolled into. You can select a lower or higher metal tier plan (Bronze, Gold, or Platinum.) You can select a different health plan that may support your doctors. For example, you may have been enrolled in a Kaiser Silver plan, but your doctors are affiliated a different medical group; you can change the plan selection.
Most of the links will take you to insurance agencies that can enroll you in a Covered California health plan. Unfortunately, some of the agents push indemnity and health care sharing ministry plans, not Covered California. Why do they do this? The commissions are higher for these plans. Once the consumer is enrolled in some of these plans, and subsequently want to terminate the coverage because they realize they did not enroll in real a real health plan, there is no support from the agency or the carrier.
Santa Barbara County sent a letter saying the couple did not qualify for Medi-Cal. They then received a letter from Covered California stating that they no longer qualified for any subsidy. When I accessed the couple’s Covered California account, all of their income information had been erased. When I looked at the transaction history on the Covered California account, Santa Barbara County Medi-Cal office had accessed the account and submitted changes.
Health insurance, at a basic level, is asset protection similar to car, life, and home insurance. Most health plans have an annual maximum out-of-pocket amount that limits your liability to outrageous health care bills in the event of an accident or sudden illness. Once the maximum out-of-pocket amount is met, the health plan covers all in-network health care expenses for the rest of the year.
When you receive an inheritance of money, that cash is an asset, no different than a savings account. The inheritance is not counted as monthly income. It is generally considered a one-time lump sum distribution. Consequently, an inheritance of money should not impact your MAGI Medi-Cal eligibility.
The minimum annual income in order to become eligible for the Covered California health insurance subsidies for a single adult is $18,756 for 2022. That is $980 higher than the minimum annual income for 2021, approximately a 6 percent increase. The minimum amount for 2 adults is $25,269 annual income. Estimated income amounts below 138 percent of the federal poverty level on the Covered California application will make the household eligible for Medi-Cal.
