Kevin Knauss: Health, History, Travel, Insurance
Posts related to how California MAGI Medi-Cal works, especially with Covered California, enrollment, termination, household income.
Now that you, your children or your entire family are now enrolled in Medi-Cal, the next challenge is finding a doctor. Virtually all of the Medi-Cal plans will be HMOs (Health Maintenance Organizations) where you will have to select a primary care physician (PCP). Your PCP will be your initial contact point for referrals to other health care services he or she may not be able to perform in their office.
The Affordable Care Act is failing families on two major issues that need immediate resolution. The employer sponsored health insurance regulation has left many spouses without affordable coverage and household income limits are placing children in Medicaid programs. Together, these two ACA regulations are unfairly fracturing the health insurance coverage for many families and need immediate changes.
The enrollment of individuals and families under the expanded Medicaid provisions of the ACA is not a slam dunk with either the mailing in of an application or clicking “enroll” on a website. A variety of documents will usually need to be sent to complete the enrollment at the county level. Not submitting the verification documents could ultimately delay enrollment for people who desperately need the insurance.
We can be fairly certain that the big push to enroll college students into new ACA health plans will result in a large portion of the students channeled into Medi-Cal plans. It is estimated that are 480,000 young adults age 19-29 that will be eligible for Medi-Cal2. If we assume a full-time student is able to work 20 hours per week, that monthly wage still puts them below the 138% of the federal poverty line ($15,865) and automatic Medi-Cal.
While most people are thrilled with the ability to get affordable health insurance through Covered California, others are trying to avoid the premium free health insurance being offered. Specifically, some families and individuals are trying to figure out how to avoid having either their children or their family automatically enrolled in Medi-Cal. Inflating the income of the household is one way side step automatic enrollment in Medi-Cal health plans.
Covered California hosted another webinar to provide a progress update of the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) website. In short, this is the website Californians will use to enroll in one of the qualified health plans offered in their area through Covered California.
California residents were invited to ask questions about the new Covered California health plans in a live chat held through Facebook this past Thursday. Ken Wood, Senior Advisor for Products, Marketing and Health Plan Relationships for Covered California, answered 47 questions over 90 minutes. While fourteen of the questions dealt with different aspects of the health plans being offered, the bulk of the questions focused on income requirements for the tax credits and coverage options for different family scenarios.
California in 2010 had 101,854 nursing facility residents, 68% on Medi-Cal, in 1,229 facilities. Cuts could force many to move.
Medicaid provides a “wrap-around” benefit for medications such as: antidepressants, atypical antipsychotics, antiretrovirals used in the treatment of HIV/AIDS
