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.
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.
The Covered California agent service representative said I was about the fifth agent he worked with to identify the missing dependent tax status question. He could see the question in his system, but I couldn’t see the question on my client application. When he indicated that Debbie was to be claimed as a dependent of Susan, the APTC monthly subsidy was awarded.
Another annoying change Covered California made was adding little pop-up windows asking for more information called One More Thing. After submitting a change to the income, Covered California wants to know if anyone is pregnant. The only way to get around this is to select the Edit button and select Nobody from the household member selection.