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Posts related to the Covered California application, consumer account, estimating income, household size, monthly subsidies, health plans, Medi-Cal, and terminations.

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Revised 2020 Covered California Income Eligibility Chart

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There really is no mystery as to why the Covered California income chart doesn’t match the Medi-Cal federal poverty level income table. Covered California is working with two different programs. They must screen for MAGI Medi-Cal eligibility based on current monthly income and the latest federal poverty levels, and, they must also determine the Advance Premium Tax Credit subsidies following IRS guidelines that use the previous year’s federal poverty levels. And if you follow all of that, you are smarter than me!

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Are Health Insurance Premium Payments Delayed With Coronavirus Emergency?

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There are a couple of different reasons why health insurance companies may be reluctant to extend a grace period beyond the current 30-day date range. The first reason is California’s expanded Medi-Cal option. If an individual or family has a sudden decrease of income – below 138 percent of the federal poverty level for adults – and they do not have employer sponsored health insurance, they can immediately apply for Medi-Cal and get coverage at no cost.

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Covid-19 Special Enrollment For Health Insurance

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Effective Friday, March 20, Covered California opened the health insurance exchange to any eligible uninsured individuals who need health care coverage amid the COVID-19 national emergency. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through June 30.

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Why is Covered California asking if I am enrolled in Medicare?

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Covered California is expanding its dragnet to catch people who may not be entitled to the Advance Premium Tax Credit (APTC) subsidy. If you are eligible for Medicare, or have other minimum essential coverage (MEC), you are not eligible for the monthly APTC subsidy.

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Kaiser and Covered California Team Up For Double Enrollment And Subsidy

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The extra $3,000 is clearly stated on the 1095-A. I have seen it. The question is, “What did Kaiser do with the extra $3,000 and how did they not figure out that they were receiving no consumer premium to attach to the monthly subsidy?”

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Let People Buy Medi-Cal HMO Plans During Corona Virus Pandemic

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Why can’t people who earn too much money to qualify for either MAGI Medi-Cal or the subsidies through Covered California just be allowed to pay the monthly capitation rate for these plans? They are less expensive than private insurance and would offer some protection from the corona virus health care costs.

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People Don’t Trust Medicare For All Because of Medi-Cal Bureaucrats

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The Change Log Table shows that Sacramento County Medi-Cal returned the client’s household size to 2 and added the deceased spouse back into the household. The only notification the client received that Medi-Cal had meddled with her account was when she received a notice from Kaiser informing the client that her coverage had been terminated.

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Insurance Agent, Broker, Producer, What are the differences?

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Occasionally, I am asked whether I am an insurance agent or a broker. The underlying premise of the question is that the person does not want their insurance options limited to only those insurance companies the agent represents. The assumption is that a broker will not steer the client into an insurance policy that he or she receives the highest commission for. For the purposes of this discussion involving health insurance, there are no brokers, we are all agents. But not all agents are equal when it comes to the health plans they represent.

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I Lied About Covered California Open Enrollment

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I was in attendance at a Covered California meeting in Sacramento where agents asked if Covered California was going to publicize the individual mandate penalty in their marketing campaign for open enrollment. Executive Director Peter Lee told the audience that Covered California marketing would focus on the new California Premium Subsidy and not the penalty. But now, Covered California is using the argument that thousands of people don’t know about the penalty, when they are in charge of making California residents aware of the individual mandate penalty.

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2020 Individual Mandate Penalty Special Enrollment Period Off-Exchange Consumers

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Consumers who are currently insured in the individual market directly through an insurer “off-exchange” may be eligible to receive financial help if they purchase coverage through Covered California during this new SEP. It is important to note that consumers who earn from 138 percent FPL through 600 percent FPL may receive state and/or federal subsidies which means they would be more likely to retain their coverage.

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