For eligible plan members only, Blue Shield will offer an option to defer up to 75% of April’s premium to remain a paid current Member / Small Group customer (i.e. must pay a minimum of 25%). For example, April premium is $1,000. Member can defer $750. April payment due is $250. So long as the Member or Small Group enrolls in the program or pays the Total Amount Past Due before the end of the grace period, the Member or Small Group will not be cancelled after the applicable grace period ends.
Post discussing premiums for health insurance, subsidy, how they are calculated, increases.
Blue Shield of California is taking additional steps to remove barriers and help its members receive the health care they need during the coronavirus (COVID-19) pandemic, announcing today it will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020.
The Social Security retirement income is really important. Your spouse may be on Medicare, and not seeking health insurance, but if they are receiving Social Security retirement benefits, that income, even though it may not be fully taxed, it must be included in the Modified Adjusted Gross Income. Many families have failed to include the Social Security retirement benefits in their income estimated and then found they earned too much money to qualify for the Premium Tax Credit subsidy and they had to pay it all back.
There are a couple of different reasons why health insurance companies may be reluctant to extend a grace period beyond the current 30-day date range. The first reason is California’s expanded Medi-Cal option. If an individual or family has a sudden decrease of income – below 138 percent of the federal poverty level for adults – and they do not have employer sponsored health insurance, they can immediately apply for Medi-Cal and get coverage at no cost.
The standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10 from $135.50 in 2019. The annual deductible for all Medicare Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019.
The family continued to wait, not paying any of the invoices they received because they figured that Covered California was working to resolve the issue. The health insurance plan was terminated by the health plan for lack of payment. If the consumer does not pay the all the premiums after 90 days, the consumer loses the right to make all the back-premium payments and reinstate the health plan. This is what happened to the family.
The HIPP program pays the medical insurance premiums, coinsurance, deductibles, and other cost-sharing obligations for the individual. The annual cost of the premiums and member cost-sharing is compared to the estimated cost of an equivalent set of Medi-Cal services. Outlined in in an ACWD Letter 09-02, DHCS uses a specific formula to determine the cost-effective nature of the private insurance over Medi-Cal FFS.
Not all family members have to have the same carrier either. Some family members can enroll with a more expensive PPO plan while other individuals enroll in an HMO from the same company or completely different carrier. I have clients where some family members have chosen the Blue Shield PPO plan and other household members are with a less expensive Kaiser plan.
For individuals transitioning into Medicare in 2019 they will see a higher Part B premium. The new Part B premium will be $135.50, up from $134.00. Many Medicare beneficiaries already in Medicare will not pay the full Part B premium because certain provisions limit the Part B premium increase to be no greater than the increase in their Social Security benefits.
So why is this significant? Because Kaiser was sending statements to the Covered California household for past due balances greater than one month. They were also sending termination notices even though they had already sent Covered California cancellation of the plan and Covered California terminated the enrollment. But Covered California will not investigate the erroneous terminations. They just tell the agents and consumers they have to deal with the health plan. In this case, the family has sent voluminous amounts of documents to Kaiser showing they made their premium payments.