Report 2016 Income to Avoid 2017 Medi-Cal with Covered California

Reporting Income Date Quick Guide Certified Enrollers

What You Need To Know:

Covered California Certified Enrollers entering consumer income into the online application (CalHEERS) need to report the correct date in the First Date Paid field in order to get the correct eligibility results. Consumers applying for 2017 coverage may incorrectly receive Medi-Cal eligibility if they do not report their current income for 2016.

The Medi-Cal eligibility occurs because Medi-Cal determines eligibility based on the date the application is entered into CalHEERS, regardless of the coverage year the consumer wishes to enroll. If income is reported with first date paid as 01/01/2017, the income will appear as $0 for the current 2016 coverage year. This will cause the application to go into review with Medi-Cal, which can delay enrollment into a Covered California Plan for 2017.

Resolution:

When entering consumer income, ensure you are capturing the income start date for the current year, regardless of the coverage year. In the First Date Paid field, enter the date any income was received for the current year. This can be any date in the past, but not further than four months into the future. If left blank, CalHEERS will default to January 1 of the year the income item was created.

Entering income this way will ensure that the application is routed to Medi-Cal only when the application is potentially Medi-Cal eligible.

Example:

Today is November 14, 2016. The consumer wishes to apply for January 1, 2017 coverage only. Annual Income: $45,000.00 since 2002. The First Date Paid field reflects the current year, 2016, first date paid, not the first date of pay for the 2017 coverage year. You can also input 01/01/2002, as it includes all of 2016.