Consumers who are identified as enrolled in MEC Medicare and a Marketplace plan through Medicare PDM should return to their Marketplace application and end their Marketplace coverage or Marketplace financial assistance. Consumers may have to pay back all or some of the APTC paid on their behalf for months they had both Marketplace coverage with APTC and MEC Medicare, when they file their federal income tax return.
Beginning April, 24 2017, Covered California will send notices to consumers to notify them they are at risk of losing their Advance Premium Tax Credit (APTC) and/or cost-sharing reductions for health insurance coverage through Covered California in 2017.
During the 2017 renewal process the incorrect Advanced Premium Tax Credit (APTC) amount was sent to the health plan for some consumers. The eligibility determination and notice the consumer received from Covered California displayed the correct APTC amount. However, because the incorrect APTC was sent to the health plans, they invoiced the consumers with overstated APTC and understated premiums owed.
Covered California has released a table of sources of income and whether they are countable toward the Modified Adjusted Gross Income (MAGI) for the monthly health insurance subsidy. The foundation for the table is the federal 1040 income tax return. The Countable Sources of Income table includes income for the monthly subsidy and whether the income is considered for MAGI Medi-Cal.
The Center for Medicare & Medicaid Services (CMS) has released a review of the rules regarding when a family becomes ineligible for the Covered California subsidy after being offered employer-sponsored health insurance. While the presentation is geared toward health insurance agents, there is good information relevant to everyone in the file. As CMS notes, gaining employer-sponsored health insurance while enrolled in Covered California is a Common Complex Situation.
The Centers for Medicare and Medicaid Services has released a Frequently Ask Questions documents discussing health insurance subsidies when a person is incarcerated in jail or prison. This includes such situations of a person being arrested but not yet convicted of a crime and those on probation and parole.
Some people qualify for big savings on their Medicare prescription drug costs and don’t even realize it! In fact, if you receive Medicare, you may be eligible for the Extra Help, which could save you about $4,000 per year on your monthly premiums, annual deductibles, and prescription co-payments.