California Health Care

Find latest news, legislation and regulations related to the California health care system. Medical coverage services in the golden state are offered through the following options:

  • Covered California: The Health Exchange Marketplace
  • Insurance Carriers: providing off-exchange medical benefits
  • Veterans Administration (VA) Health Care Coverage
  • Medi-Cal
  • Prison Health Care for California

Health care in California has gone through radical changes since the passage of the Patient Protection Affordable Care Act (PPACA) in 2010 and the implementation of Health Care Reform in 2013. Obamacare plans in California are sold through the state health insurance exchange, Covered California.

Individuals, families and businesses can enroll on a health care plan through Covered California, through Medi-Cal, through a health insurance broker, or by contacting a health insurance carrier directly. Popular carriers offering health insurance in California include Anthem Blue Cross, Blue Shield of California, Kaiser Permanente, Health Net, Molina and United Healthcare. For rates and benefits, click California Health Insurance Quotes. Open Enrollment 2017 is from November 1, 2016 to January 31, 2017. Outside of that window, you may apply during the Special Enrollment Period as long as you have a qualifying life event.

Government agencies that regulate health care in California include the California Department of Insurance, the California Department of Health Care Services, the Department of Managed Health Care (DMHC) and Ombudsman. The DMHC and Ombudsman offer protections and legal assistance for the consumers of health care in California.

 

by Wendy Barnett

Covered California recently sent out an e-mail to members with “Helpful Tips.” The March 2017 e-mail includes guidelines on what services are free and how to get started using the plan. As a health insurance agent I am surprised that I commonly hear from members that they have never used their plan. This is really unfortunate since there are free benefits that members can use to help them stay healthy. I really encourage members to follow the “Getting Started” steps below, that way they will be set up to use their plan much more easily if something urgent arises. (more...)

Posted: March 25th, 2017 under Covered California Insurance

by Wendy Barnett

Covered California offers Small Business and Group Health Insurance in California to businesses with 1-100 employees at any time throughout the year and seeks to better the program experience by listening to customer concerns. For instance, the concern about a delinquency notification policy was recently addressed.

Background: Delinquency notifications were causing confusion

Covered California for Small Business (CCSB) had been sending out notices to both the employer and to employees whenever a policy was late on a premium payment. Policies are given a 30-day grace period for payment to be made, and notices to such effect were going out to both employers and employees on the 5th of each month. This was causing confusion for all involved. (more...)

Posted: March 16th, 2017 under Covered California Insurance , Small Business Health Insurance

By Wendy Barnett

No Consent = No Tax Credit

shutterstock_357403964In late December of 2016 Covered California found a bookkeeping error where certain consumers were erroneously told that they would receive a tax credit for their renewed Covered CA plan when in fact their tax credit would be removed entirely. The removal of the tax credit had to do with whether or not a Covered CA applicant gave their consent to check their income taxes.

Did you give your consent to check your income taxes?

Consumers must give Covered CA consent to check their tax records at renewal time each year in order to receive their Advanced Premium Tax Credit (APTC). This allows Covered CA to verify their income to make sure they still qualify for the tax credits that help lower their monthly premiums.  Members can give this consent for up to 5 years so their APTC can be renewed automatically at renewal time. But for those who did not give consent to check their income taxes, the APTC will not get applied for the New Year, and their health insurance plan will be billed at the full charge, even if they qualified! (more...)

Posted: March 10th, 2017 under Covered California Insurance

by Wendy Barnett

Covered Californiashutterstock_316264043 (1) confirmed that they gave erroneous tax credit information to insurers for approximately 25,000 policy holders. This resulted in members receiving incorrect bills for the month of January, 2017. Covered California has, since then, corrected the wrong tax credit information with the insurance carriers. They have also aggressively reached out to affected members to inform them of the error and their options.

How will this affect you as a Covered CA member?

  • January’s bill may be wrong. In most cases the bill will be lower than anticipated.
  • Expect a higher bill in February. Those affected by this issue will receive a corrected bill from their insurance carrier for February.  In most cases, the bill will be higher, in some cases considerably higher as the correct tax credit amount will be lower.
  • It will be at your Insurance Carrier’s discretion whether or not to charge you the difference in price to make up for January.

(more...)

Posted: March 10th, 2017 under Covered California Insurance

by Wendy Barnett

shutterstock_381296368 (1)Near the end of February, Covered California sent out notices to members receiving tax credits as reminders that they should have received an important tax document – their IRS Form 1095-A.

Information in the Covered CA notice includes:

  • Where to call if you did not receive your 1095-A (1-800-989-2199)
  • Why you need your 1095-A form
  • Whether or not you can file your taxes without your 1095-A
  • Information about reconciling your Tax Credit
  • How you may be able to receive free tax preparation help

(more...)

Posted: March 6th, 2017 under Covered California Insurance