Kevin Knauss: Health, History, Travel, Insurance
Posts related to how California MAGI Medi-Cal works, especially with Covered California, enrollment, termination, household income.
Blue Shield of California announced that it was getting a slice of the lucrative government Medi-Cal pie with its acquisition of Care1st of Los Angeles County. Blue Shield has been missing the easy money of Medi-Cal payments that Blue Cross, Health Net and Kaiser have been receiving from different California counties when they offer a Medi-Cal managed care HMO […]
Contrary to Department of Health Care Services (DHCS) statements in their Medi-Cal Essentials webinar, agents will not be receiving any payments for assisting clients that were enrolled into Medi-Cal through a Covered California application in the near future. Recent email communication from Covered California to Certified Insurance Agents suggests thatcompensation of approximately $58 per Medi-Cal […]
Have you ever wondered how one of your Covered California accounts got changed when you know that neither you nor the client touched application? Covered California accounts are being mysteriously changed without the applicants knowledge or consent. If you check the Transaction History of the account you might find that this mysterious user known as […]
Throughout the past year of enrolling individuals and families into the Covered California health plans, Certified Insurance Agents were in the dark when it came to Medi-Cal. The Department of Health Care Services held a webinar on July 31st to review of the essential basics of the Medi-Cal program. Even if you only review the […]
Medi-Cal was one of the biggest mysteries during open enrollment in the new ACA health plans. Even though Covered California advertised a “no wrong door” approach to signing up for health insurance, when a client had to go through the Medi-Cal door, not even Covered California could tell them what to expect. Finally, seven months into the expanded Medi-Cal program, the Department of Health Care Services has finally put together a presentation that goes over the various parts of Medi-Cal and how the system works.
Through casual conversation and on various Internet forums numerous agents and brokers have mentioned they arent getting paid commissions for business they submitted through Covered California. Is there a crisis of commissions not being paid to Certified Insurance Agents? Without reliable data from the agent community it is hard to tell if the missing commissions […]
Medi-Cal health insurance premiums paid to managed care health plans or Health Maintenance Organizations (HMOs) is a sizeable sum of money. The California Department of Health Care Services estimates the average monthly cost for each Medi-Cal beneficiary is $611. Expanded Medicaid, where families earning less than 138% of the federal poverty line are automatically enrolled in Medi-Cal through Covered California, encompasses a population who is often healthier and use fewer health care services than beneficiaries who qualified under the original Medi-Cal rules.
As of May 1, 2014, limited dental services will be included for adults, 21 years and older, that are on Medi-Cal. Adult dental Medi-Cal services were removed during the California budget crisis in 2009. Some counties may require adults to enroll in a dental manage care plan while others will offer a Fee-For-Service program. The Denti-Cal adult services will be the same whether they are obtained through a plan or through a Denti-Cal participating dentist or clinic. The challenge for adults in rural counties will be finding a dentist that accepts Denti-Cal.
Different interpretations of monthly verses annual income estimates on the part of Covered California and county Medi-Cal administrators have the potential to leave many Californians who are drawing unemployment benefits without any health insurance. At least one person has been denied the ability to purchase a private health plan with ACA tax credits while being simultaneously excluded enrollment in the ACA expanded Medi-Cal health plan. The conflicting interpretations can leave many people ineligible for either ACA tax credits or Medi-Cal.
Individuals and families who have enrolled in health plans through Healthcare.gov, or a state exchange like Covered California face new challenges as they report income and household changes. Families reporting changes to household size and income may also be triggering changes to their health plan. These changes may result in the entire family becoming eligible for Medicaid, being shifted into a different Enhanced Silver plan or losing the Advance Premium Tax Credit all together.
