The income columns that have been updated to reflect the higher federal poverty levels are 138%, 213%, 266%, and 322%. All those income columns, based on household size, correspond to Medi-Cal eligibility for adults, Medi-Cal for Pregnant Women, Medi-Cal for Children, and Medi-Cal Assess Program and CCHIP for children in counties in San Francisco, San Mateo, and Santa Clara counties. The other income columns that are not tied to Medi-Cal eligibility remain unchanged from the 2023 open enrollment period.
Household Income Levels
Posts related to eligibility for health care programs based on household income such as Covered California, Medi-Cal, Medicare usually based on federal poverty levels.
Tax Credit or Repayment? Health Insurance Subsidies for 2022
Lines 24 through 26 of Part II of form 8962 determine if the household is eligible for an additional Premium Tax Credit. In this situation, the final household MAGI was slightly lower than estimated income amount of the Covered California application. The result is that the household is eligible for an additional $23 in Premium Tax Credit. They were eligible for an annual subsidy of $16,832, but only received $16,809.
MAGI Medi-Cal Income Eligibility For 2023 Increases Over 6%
In 2022, a single adult earning $1,564 or less per month (138% FPL) was eligible for Modified Adjusted Gross Income (MAGI) Medi-Cal. The 2023 FPL income levels increases approximately 6.70 percent. This means that a single adult can qualify for MAGI Medi-Cal in 2023 with a monthly income of $1,677. For 2 adults, the household income can go as high as $2,269 per month and still maintain Medi-Cal eligibility.
Medi-Cal versus Covered California Income, Who Decides?
Because Medi-Cal workers don’t understand or comprehend some of these sources of income, they terminate the Covered California enrollments of adults and children. This creates chaos for these families. An unknown, uninvited, and unauthorized individual accesses a Covered California application and makes an uneducated determination of the household’s income. Then this same elusive individual terminates coverage for individuals and families, some of them undergoing health care treatment with specific providers not in any Medi-Cal HMO network.
Relief for Crippling Employer Health Insurance Premiums – Covered California
The subsidy benefit for families burdened with crippling employer group health insurance premiums can be enormous. Unfortunately, acquiring the necessary employer information and calculating the affordability percentage can be daunting for some families. However, Covered California has created some worksheets and tools to help in the process.
Why Are Your Children Suddenly Medi-Cal in Covered California?
Many people do not update their income every year. While the income stays static, the threshold for Medi-Cal creeps up. The 2022 federal poverty levels are being applied for the 2023 Covered California subsidy and Medi-Cal eligibility. Many families are being caught by surprise that their current income is too low to maintain subsidies for their children.
That Awkward Income Estimate for Covered California
People mistakenly believe that their past federal income tax return is used for their future income estimate. The past tax return can be a guide to estimating the income, but it is not final determination. One problem with federal tax returns is they usually don’t capture Social Security retirement benefits or tax-exempt interest, both of which are included in the Modified Adjusted Gross Income.
Income and Plan Changes After Covered California Passive Renewal
When you continue to review the plan options, the next screen is a confirmation of your existing health plan. Click on Back to Shopping. Another popup window will show and is sort of a warning. However, to review the options, click on Remove Existing Plans & Go Shopping. You will then be shown all the plans for the entire household or selected individual with the applicable subsidy applied.
Combining Employer Health Plans and ACA Subsidies for Spouse and Dependents in 2023
The total annual premiums for the entire household are used for the affordability test for the other household members. (This calculation can be made on a monthly basis as well.) The total annual premiums for everyone offered the lowest cost health insurance is $15,147.84 That annual premium is 18.93 percent of the $80,000 estimated household income. Because the health insurance expense percentage is greater than 9.12 percent, it is deemed unaffordable, Pat, Bobby, and Catlin can enroll in a market place ACA health plan with the subsidies.
2023 Covered California Open Enrollment Income Chart
The income chart uses columns with specific percentages to display the annual income amounts necessary for different program eligibilities based on household size, rows. What can be confusing is that an income chart will be published where the math doesn’t work. For example, the federal poverty level (FPL) income for an individual is the 100% column. The next column is 138% FPL. On the 03/2022 income chart, the annual income amount in the 138% FPL column, $18,755, is higher than the 100% column of $12,880 x 1.38 = $17,774.