Posts tagged with "MediCal"

Highlights of the Senate Healthcare Bill

The Senate health bill resembles the House health bill with a couple of changes. I’m sure there will be tons more changes before this passes. Here are some of the highlights:
 
-Eliminates ObamaCare’s mandate that every American carry insurance.
 
-The Senate also backs away from some last minute House concessions that would have allowed states to opt out of several protections for those with pre-existing conditions, but insurers would not be allowed to charge higher premiums to those with pre-existing conditions.
 
-Subsidies will continue for 2 years although they are coming up with a new formula to determine who gets a subsidy and who much. Fewer middle class folks would get help because only those earning up to 350% of the poverty level would qualify, rather than the 400% threshold contained in Obamacare.
 
-Eliminates the ‘Enhanced’ plan benefits.
 
-Loosens requirements in Obamacare that health plans all cover a basic set of benefits like no limits on coverage.
 
-Phases out Medicaid’s expansion program and caps Medicaid (MediCal in CA) spending. It basically puts the entire Medicaid program on a budget, ending the open-ended entitlement that now exists.
 
-Repeals, retroactively to the beginning of 2016, the “employer mandate,” which requires large employers to offer health insurance to workers or be fined.
 
-Repeals the 3.8 percent tax on net investment income, to the start of 2017.
 
-Strips Medicaid funds from Planned Parenthood clinics for one year.
 
-Health plans that offer abortion services would not be eligible for the subsidies.
The bill is likely to come to the Senate floor next week. They’d like to get it done before the 4th of July recess.
 
The Senate has 52 seats and the bill would have to pass by 50 with Vice President Mike Pence breaking the tie.  They may have already lost one vote — Senator Rand Paul, Republican of Kentucky, has indicated that the bill is too liberal for him.
 
Resources:
http://www.latimes.com/politics/la-na-pol-senate-obamacare-20170622-story.html
https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/06/22/the-health-202-here-s-what-s-in-the-senate-health-care-bill/594aa367e9b69b2fb981dde9/?utm_term=.3064dd1601a4
http://www.cnn.com/2017/06/22/politics/senate-health-care-bill/index.html
https://www.nytimes.com/2017/06/22/us/politics/senate-health-care-bill.html

On Covered CA and getting a subsidy on your health insurance? BE AWARE!

Opening your mail as you normally do and to your surprise, there’s a letter from Covered CA saying ‘Congratulations, you’re eligible for MediCal’!  Well, in all fairness, they don’t actually say ‘Congratulations’ but you get the gist.  This is what is transpiring right now as thousands of Californians that receive a subsidy, are getting pushed into MediCal because their income on their Covered CA account is $1 too low.  Yes, you read that correctly.  If you are $1 off, you too could lose your doctor!

Why?  The government released the 2017 Federal Poverty Limit Chart that gives guidance to which plans you are eligible for based on your MAGI (modified adjusted gross income) that you reported in Covered CA.  Why they don’t release this at year end, we’ll never know.  That would make too much sense!  For most people, your MAGI is Line 37 on your personal tax return.  If you receive social security and/or tax exempt interest, that’s added to your AGI to come up with your MAGI also.  If that figure is off by $1, instead of that amazing Silver 94 plan you’re enjoying, you could get that wonderful letter saying ‘Welcome to MediCal’.  Or if your MAGI is $1 to high, you could be pushed from the wonderful Silver 87 plan to the not so great Silver 73 plan (HUGE difference in benefits!).  It is vitally important that you check your Covered CA account, look at what income is reported to see if you are in danger and if so, get it changed asap!  I would even go so far as building a buffer for when it’s increased next year.

This mostly affects self employed people because you’re able to write off expenses from your income.  And the income in your Covered CA account is a guess-ti-mate anyway because how on earth are we supposed to predict the future?  I’m sure your tax person could find an extra dollar or two.  And if they can’t, we’ll get you to someone that can!  Are you making too much money?   Did you know that you could put money into an IRA or 401(k) and that would lower your MAGI?  And if you’re self employed, always make sure your tax pro is deducting your health insurance.

Here’s an idea!  Would you rather have someone deal with this for you and not have to pay them any extra?  It’s your lucky day!  While Covered CA really doesn’t advertise it very well on their website (not sure why), you can have an advocate on your side to take care of things like this and it doesn’t cost you ANYTHING extra!  You’re read that right, you won’t pay one extra dime to have us keep up with things like this AND MUCH MORE!   We accept just what the insurance companies pay us.  If you already have an agent and they aren’t pro-active like we are, while they may be really nice, it’s time to change agents!  Once we find out that Covered CA is utilizing the new chart, we review each account to see if they are in danger.  If Covered CA has to be called or your case needs to be appealed, we do that for you. We’re that breathe of fresh you’ve been looking for 🙂

Call or email us and we’ll walk you through how to easily add us as your advocate on your Covered CA account or your ‘off exchange’ health insurance plans.

Debbie Hoffman, Insurance Designs

323.455.4961

debbie@debbiehoffman.com