The Medi-Cal representatives also confirm that erroneous information can pop into Covered California applications after an individual or family has been terminated from Medi-Cal. Once a person is deemed no longer eligible for Medi-Cal, the SAWS Soft Pause is released and the individual and family can then enroll in a Covered California plan with the tax credit subsidy. Unfortunately, the data on the Covered California can be missing or in accurate from what was originally entered.
You must have been enrolled in a Medicare Advantage medical plan to take advantage of the MA OEP. If you never enrolled in a MA or MA-PD, you can’t join one during the MA OEP. You can’t switch standalone Part D Prescription drug plans during the MA OEP. Additionally, if you go from a MA-PD to a MA plan, you can’t add a standalone Part D Prescription Drug plan. The MA OEP doesn’t apply to Medicare Savings Accounts (MSAs) or Cost Plans.
When I looked at the submitted application – there it was – I had to have selected the permanently moved to California QLE which is below loss of coverage. The permanent move to California QLE triggers the standard effective date of the 1st of the following month, in this case August 1st. So the family really did not have insurance for July!
The increased revenue is also in light of reducing health plan assessment from 4% of the gross premiums down to 3.75% for the individual and family plan market. The proposed operating budget for FY 2018-19 is $340.2 million. This represents a 6.55 increase over the FY 2017-18 budget or an increase of $20,686,242.
Because Peter did not have health insurance in the last 60 days, he technically doesn’t qualify to enroll in a health plan in California. But when Peter moves out to California, his job has not started and he has no monthly income, he is just living off of his savings until the job starts in early summer. Because Peter has no monthly income, he qualifies for MAGI Medi-Cal.
A significant drop in household income does not qualify you to apply to Covered California for the tax credit subsidy to lower your monthly health insurance premium. If you are already in Covered California, you can report a change of income and then select a different health plan.
Both Health Net and Blue Shield have wasted thousands of hours of time for consumers, agents, and their customer service staff. Tempers have become short and patience has run thin. And as of December 21st, a month after some people have applied for health insurance, 10 days before the plans are to become effective, many families don’t know if they will have insurance on January 1, 2018.
Upon submitting your application for 2018, the Covered California system checks your eligibility for 2017. If the system finds you ineligible, which you mostly likely are because you are not applying for 2017 coverage, the system automatically generates a letter informing you that you are not eligible for 2017 coverage.
I don’t mind enrolling people into Medi-Cal. I’m a one-person operation and I enjoy chatting with people. But I have to draw the line with people who insist on me answering a million questions and then failing to give me the appropriate information to complete their Covered California Medi-Cal eligibility application. I also will not knowingly participate in any misrepresentation or fraud so a person can either be enrolled in Medi-Cal or be determined eligible for the tax credits through Covered California.
After Covered California acknowledged at the January 2017 Board meeting that they had system issues that affected over 40,000 consumers, new enrollment problems seem to be boiling up. Some consumers have reported that household members who are ineligible for Covered California family dental plans have been automatically enrolled in dental insurance in 2017. In some very rare instances, the Covered California system is allowing consumers to actively enroll in two different subsidized health plans.