California MAGI Medi-Cal

Posts related to how California MAGI Medi-Cal works, especially with Covered California, enrollment, termination, household income.

Medi-Cal Individual Household Size Flowchart

December 26, 2015 By Kevin Knauss 7 Comments

The Department of Health Care Services (DHCS) has developed a Medi-Cal household size flow chart. The DHCS Guide for Calculating MAGI Medi-Cal Individual Household Size was originally developed to help county eligibility workers ascertain the actual household size under the new Affordable Care Act (ACA) rules. The newly expanded Medi-Cal eligibility under the ACA revolves around on IRS definitions for tax dependents and non-filer rules. Because families can be so diverse and the rules regarding what constitutes a tax family so complicated, the flow chart for determining household size was created.

How I failed as a health insurance agent

December 5, 2015 By Kevin Knauss 8 Comments

I screwed up big time on behalf of a man with a serious illness. The end result is that he will be without health insurance for the month of December. Even though there are other people who failed in this situation, I have to take the ultimate responsibility that he might have to shoulder thousands of dollars in health care expenses that would have been covered by health insurance. I broke the business rule of never following your heart, and always trust your gut.

California health agents assist 429,365 Medi-Cal eligible individuals

October 10, 2015 By Kevin Knauss 7 Comments

Covered California Certified Insurance Agents assisted 429,365 individuals for possible enrollment into the expanded ACA Medi-Cal health insurance from January 1, 2014 through July 31st, 2015. The Medi-Cal assistance enrollment figure comes from a Public Records Act Request that I submitted in early October of 2015 to Covered California. As the $58 compensation to agents for Medi-Cal enrollments ceased over the summer I felt it was important to learn the level of agent involvement with funneling Californians in Medi-Cal health plans.

Mixing health plans from Covered California, Med-Cal and off-exchange

September 21, 2015 By Kevin Knauss 12 Comments

Every family is unique in their health care needs. There are situations when each family member may require a different health plan to meet their particular health challenges. Unfortunately, many families who enroll in a health plan through Covered California are unaware that not all the family must be on the same health plan.

Accessing benefits under dual eligible special needs plans

August 20, 2015 By Kevin Knauss Leave a Comment

Anthem Blue Cross of California Medicare Advantage dual eligibility with Medi-Cal Special Needs Plans May 30, 2015 This guidance is generally applicable for all health insurance companies that offer Medicare Advantage Special Needs Plans for dual eligible beneficiaries. Dual Eligibles (Duals) are individuals who are entitled to benefits from both the federal Medicare and state-run […]

Covered California funds Navigator program, cuts agent compensation

August 1, 2015 By Kevin Knauss 10 Comments

Covered California announced in mid-July they were awarding $10 million in grants to a Navigator program that performed poorly in 2015. Two weeks later Covered California sent out a letter to agents that they would no longer be compensated for assisting individuals and families who are determined eligible for Medi-Cal. For the 2015 open enrollment […]

How do I report an income change to Medi-Cal?

July 8, 2015 By Kevin Knauss 393 Comments

For many individuals, families and their children that were award a Medi-Cal health plan based on their estimated Modified Adjusted Gross Income reported through the Covered California application, it can be a daunting task to report a change of income to Medi-Cal. As we have all learned, once Covered California hands of the enrollment to […]

Appointing a Medi-Cal Authorized Representative

June 30, 2015 By Kevin Knauss Leave a Comment

Of the nearly 3 million Californian’s enrolled in Medi-Cal, Covered California estimates that approximately 2 million became newly eligible under the ACA expanded Medi-Cal rules. Many of the new Medi-Cal members are working families and individuals. They have little time to sit on hold with their local county social services department to correct Medi-Cal errors […]

Five paths to California health insurance

June 28, 2015 By Kevin Knauss Leave a Comment

In California there are essentially five different paths to getting health insurance. Each of the different options have varying conditions and restrictions. Below is a summary of the five paths to California health insurance. There is also a short video you can watch titled California Paths to Health Insurance which also explains the five different […]

Why are my children Medi-Cal? Annual vs. Monthly income

April 13, 2015 By Kevin Knauss 59 Comments

Many parents are surprised to learn that their children are placed in Medi-Cal after completing the Covered California health insurance application. Medi-Cal eligibility is determined by the monthly household income, not the annual Modified Adjusted Gross Income. If the monthly household income is below 266% of the federal poverty level (FPL), but above 138% of […]

« Previous Page

Menu

California MAGI Medi-Cal