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.
You will want to check your Covered California account. If the 2024 year is highlighted and it says Apply Now, you are not enrolled for 2024. You need to push the application through the process. All of the information is in the system, you just have to resubmit the application so you can select a plan for the new year.
IEHP appears to have very competitive rates for the Bronze and Silver metal tier health plans. They are less competitive at the Gold and Platinum levels. IEHP is the primary Medi-Cal managed care plan for the 2 counties. With the end of public health emergency, many Medi-Cal beneficiaries may no longer be eligible and will be transitioned to Covered California private health plans with the health insurance subsidies.
While the health insurance companies calculate your monthly health insurance rate based on your age and where you live, the Silver plans strongly influence your monthly health insurance premium through Covered California. Specifically, the subsidies through Covered California are based on making the second lowest cost Silver plan (SLCSP) affordable, regardless of what you plan […]
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.
The orange percent column titles represent dollar amounts pertaining to the eligibility for Medi-Cal programs. For example, adults with incomes under 138 percent of the federal poverty level are eligible for Medi-Cal. There are specific columns for Medi-Cal for Pregnant Women, Medi-Cal for children under 19 years of age (266%), and Medi-Cal Access Program that corresponds with expanded children’s Medi-Cal in certain Bay Area counties (322%.)
The family did not understand what was going on. Why was their subsidy unilaterally changed by Covered California with no warning? They did not trust Covered California to get the numbers correct. I created a spreadsheet to see if the new subsidy and subsequent totals matched what they were eligible for at the estimated income.
Annual income. When entered on income section, Covered California will take the total amount and divide it by 12 and distribute an equal amount in each month. For example, you enter an annual income amount of $12,000 beginning in January. Each month through December will be allotted $1,000 to add to your monthly income and annual income totals.
If you never check your Covered California secure email box, opt to receive important letters delivered to your home address. The notices will alert you if you are losing your subsidies, health insurance, or being put into Medi-Cal.
Health insurance agents are not paid by Covered California. We are paid by the health plans, either PMPM or a percentage commission. There are 13 different health insurance carriers and 13 different agent commission structures.
Sue and Bob received $3,840 in excess Advance Premium Tax Credit for the year. Because their final income is over 400 percent of the federal poverty level, they must repay all the excess health insurance subsidy.
