Covered California has updated their online application for 2016 open enrollment to automatically determine the eligibility of former foster youth and pregnancy coverage for Medi-Cal programs. In previous online versions the applicant was directed to the respective program for more information and final eligibility determination. In many situations the new Covered California enrollment website will help place the individual directly into the program they are eligible for.
The purpose of this letter is to provide counties with guidance regarding fluctuating or self-employment income, and the use of projected annual income when transmitting income to the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) to calculate MAGI. Self-employment or fluctuating income may include income received from self-employment, partnerships, s-corporations, royalties, estates, trusts and real estate rentals.
Recognizing that we need both access and affordability, today we issued a notice to all 50 state Medicaid directors and sent letters to the CEOs of several drug manufacturers about providing access to therapy for Hepatitis C patients. Our notice to state Medicaid directors reminds states of their obligation to provide access to these promising therapies (consistent with section 1927 of the Social Security Act) based on the medical evidence, and that they have tools available to manage their costs. Our letter to manufacturers asks them to provide us with information on pricing arrangements and asks them for ideas to support the provision of these lifesaving medications to Medicaid programs at sustainable prices.
California Department of Managed Health Care (DMHC) Director Shelley Rouillard has issued an order approving Blue Shield of California’s (Blue Shield) acquisition of Care1st Health Plan (Care 1st). “This order brings Blue Shield into the Medi-Cal program and requires the plan to improve quality and access for Medi-Cal beneficiaries. Prior to approval, my team performed an exhaustive review of all aspects of the proposed transaction, performed complex legal analyses, conferred with external experts and considered all public comments,” said Director Rouillard.
If you are enrolled in Medicare, you do not need to do anything with Covered California. If you have Medicare you are covered. No matter how you receive your Medicare benefits, whether through Original Medicare or a Medicare Advantage Plan, you will have the same benefits and security you have now. You will receive new benefits, such as more preventive services and increased savings on brand-name drugs.
Pursuant to the California State budget enacted for fiscal year 2015-2016, however, payments will no longer be made for enrollments in Medi-Cal submitted after June 30, 2015.
What’s the difference between a Covered California enrollment for a subsidized private plan and Medi-Cal? Nothing when assisted by a Certified Insurance Agent. A Medi-Cal enrollment takes just as much knowledge, experience and time to perform for an agent as an enrollment for a private plan through Covered California. Yet, a Medi-Cal enrollment only yields […]
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 […]