Kevin Knauss: Health, History, Travel, Insurance
Posts related to the eligibility for enrollment in a health insurance plan, Covered California, Medi-Cal, Medicare, small group plans.
The confusion lies in the statement that the consumer is not eligible for the California Premium Subsidy. The California Premium Subsidy program is completely separate from the federal Premium Tax Credit subsidy. You can be eligible for the federal subsidy but not the State subsidy. If your income is over 400 percent of the federal poverty level, you are not eligible for the federal Premium Tax Credit subsidy, but you may be eligible for the State subsidy.
Is Covered California the only place to buy health insurance? No. You can buy a plan directly from one of the health insurance carriers available in your region. But there will be no subsidy to lower the monthly premiums. Enrollment into a health plan directly from the carrier is called off-exchange, as opposed to purchasing a plan on-exchange through Covered California.
Will I be able to keep my current health plan? If you have a health plan bought directly from a health insurance company – also known as off-exchange – you might be able to enroll in the same plan. Not all health plans offered direct to consumers off-exchange are available through Covered California. For example, if you have a Kaiser Silver HDHP HSA compatible plan, it is not offered through Covered California. You would need to select one of the plans Covered California offers in order to get the subsidy.
Covered California has developed a reprieve from immediate reporting to SAWS in the event of an error on the application that triggers Medi-Cal eligibility. The one-day delay in reporting the eligibility results to Medi-Cal is outlined in the CalHEERS 19.7 release scheduled to be implement on July 22, 2019.
The $1 increase in wages per hour between 2018 and 2019 is an 8% increase. The FPL has been increasing approximately 1% every year. But if we assume the FPL increases 2% that would put the new Medi-Cal monthly income level at $1,425. The increased minimum wage for 2019 still makes the individual working 30 hours per week ineligible for MAGI Medi-Cal.
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.
If Bribes are a legitimate source of income for Medi-Cal why not for Covered California I thought? When I checked the 2016 Covered California Countable Sources of Income table, Bribes was suspiciously missing from the list. Why is Covered California hiding this significant source of income for many politicians from their consumers?
The Western Center On Law & Poverty has put together a comprehensive guide to the Medicaid program in California known as Medi-Cal. Published in March 2016, there are bound to be changes to many of Medi-Cal’s programs, conditions, and eligibility in 2017. Titled Getting and Keeping Health Coverage for Low-Income Californians: A Guide for Advocates is 375 pages long and covers many topics from eligibility, citizenship, enrollment, re-determination, and the variety of programs Medi-Cal offers such as Children’s Health Insurance Program, Medi-Cal Access Program (MCAP) for pregnant women.
Like a mugger coming out of the shadows, San Diego County Medi-Cal worker(s) mugged a family enrolled in Covered California and stole their health insurance for 2107. The attack was unprovoked as the couple had not been in Medi-Cal and don’t have any children in Medi-Cal. However, Covered California reported the family to San Diego County because the family fit the profile of a household who they think aren’t smart enough to estimate their own income for 2017.
The Northern California mother was distraught to learn that her daughter, who she thought was attending college in San Jose, was in jail. The letter from Covered California clearly stated under her daughter’s name, “The records show that you are incarcerated (in jail or prison).” For this woman, for whom English is a second language, she was panicked that her daughter was in jail, her daughter had lied to her, and the whole family might lose their health insurance. In reality, this cruel hoax on the mother is the result of a miserably drafted eligibility letter using questionable data sources.
