If a consumer does not like their plan or rate, they must make changes to their account and actively renew their coverage by December 15th for a plan effective date of January 1, 2019. Changes to the account and plan selection between December 16th and January 15th will have an effective date of February 1, 2019.
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.
For the family of a small business owner, the reduction of the MAGI because of the 20% deduction could drop any dependents under 18 years old into Medi-Cal. A family of four earning $70,000 makes all the household members eligible the tax credit subsidy through Covered California. If the family reduces their income by the 20% deduction, the new income is $56,000. That is below 266% of the federal poverty level for a family of four and all dependents 18 and younger are then deemed eligible for Medi-Cal.
Over the last couple of years Covered California has been redesigning different parts of their online application to be less confusing to consumers. They have also enhanced sections such as the income portion to help guide consumers in selecting the correct entries. The document upload section is one of the last sections to get a face lift.
Today, the Centers for Medicare & Medicaid Services (CMS) issued the HHS Notice of Benefit and Payment Parameters for 2019. The final rule will mitigate the harmful impacts of Obamacare and empower states to regulate their insurance market. The rule will do this by advancing the Administration’s goals to increase state flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce unnecessary regulatory burdens imposed by the Patient Protection and Affordable Care Act.
2018 FPL guidelines are updated for Medi-Cal determinations only and will not affect eligibility for Covered California consumers. The Covered California 2017 levels are used for the 2018 benefit year.
The 2018 guidelines reflect the 2.1 percent price increase between calendar years 2016 and 2017. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family and household sizes. Included with this informational bulletin is the 2018 Dual Eligible Standards chart that displays the new standards for the Medicare Savings Program categories.
Once the document has been uploaded it will show up in the Documents & Correspondence table. You then want to go to the Action column, click on the drop down menu Select One, and select Submit as Verification Document. This will bring up a popup window (make sure you’re the popup blocker of your web browser is disabled) where you can select the household member, the document category, and the type of document being uploaded. Then click Submit.
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.
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.
If you own a small business or receive income for a service you provide, and most likely file a schedule C with your tax return, you should consider having your estimated taxable income reviewed by your tax planner. The IRS has noted that as they develop guidance for all of the changes to the tax regulations for 2018 they will be posting them on their website.