Covered California and ACA related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the ACA and Covered California knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

How Long Does it Take?

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Question: I signed up with KP and made the initial payment on CC over the weekend. I called KP today and it said it does not have the application nor the payment yet and may take 4 weeks for the info to show up in its system. Does it really take that long?

Answer: No. This business of putting you off for 4 weeks is just lazy or incompetent, probably both. Call Covered California and confirm that your enrollment is correct in their system. When it is, ask them to resend the enrollment to Kaiser and get an incident number from CC. Wait a couple of days and call Kaiser back with the incident number. If you get the 4-week BS again, demand to speak to a supervisor.

Deadline Extension?

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Question: Does the recent extension for enrollment by Dec 21st ( vs Dec 15th) for 1/1/15 effective dates apply only to applications already started by Dec 15th? Or can agents/CIAs assist any New Individuals with applications/enrollments by then?

Answer: Covered California has extended the deadline for January 1, effective date to midnight Sunday, December 21 for all applicants, agents and consumers.

Change Plans after Dec 15th?

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Question: Can I switch plans in 2015 if I decide to do so?

Answer: Yes. The open enrollment period ends February 15, 2015. You can make changes until that date.

Children Forced into Medi-Cal?

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Question: Why am I only being given the option for Medi-Cal for my children (age 5) on our CoveredCa application? We want them on our chosen plan (a Blue Shield PPO) but Covered Ca is not allowing that option. Our income is far above the Medi-cal limits for a family of 4.

Answer: For a 3-person household, your income would have to be $50,000 or more for the children to be eligible for subsidized private insurance while it only has to be $20,000 or more for the adults to be eligible. Why is that? It's a lot cheaper to cover people on Medi-Cal than to subsidize them with private insurance. Ultimately, it costs the taxpayers less and reduces the overall cost of healthcare.

Find Providers for Anthem Blue Cross?

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Question: How do I find providers for anthem blue cross under covered california?

Answer: To view a list of in-network doctors for your Anthem individual health plan:

1. Go to www.anthem.com/ca.
2. Under Useful Tools on the right, select Find a Doctor.
3. Under Search by selecting a plan/network, go to Select a state.
You can enter the name of your state or select it from the
drop-down list.
4.Under Select a plan/network, you can enter the name of your
plan/network or select it from the drop-down list then choose
Select and Continue.
5. Using the drop-down boxes, select what type of doctor and the
location you're looking for, then select Search.
6. For more info about a provider (like skills and training), just select
that name in the directory.

Question: CC qualification is based on income only while Medi-Cal is based on both income and assets. So if a person with no income but has more than $2,000 in the bank would not qualify for neither CC nor Medi-cal?

Answer: No. Qualifying for Medi-Cal no longer considers assets if one applies through the Covered California. So, no, a "low-income" applicant cannot be found ineligible for both. On the other hand, if one applies for Medi-Cal directly through the DHCS, assets are still considered. Go figure!

Question: If an employer offers “affordable” coverage for the employee, but the family cannot afford the dependent coverage and the family income is below the Medi-Cal eligibility threshold, is the family still eligible for Medi-Cal? Is the employee disqualified from Medi-Cal by the “affordable” employer plan? If so, are the wife and kids eligible for Medi-Cal?

Answer: Under the ACA, qualification for Medi-Cal is completely separate from subsidy-eligibility rules. Employees, will not be disqualified from Medi-Cal if their employer provides benefits, whether or not those benefits meet affordability guidelines. (This answer was provided by expert agent, Anne Kelley.)

Reporting Border-Line Income?

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Question: My income puts me on the border line of me getting premium assistance or Medi-Cal. It fluctuates greatly from month to month. Would I get switch back and forth between CoveredCA and Medi-Cal?

Answer: If you estimate your income for 2015 to eligible for Covered California premium assistance, you will not be switched to Medi-Cal during the year unless you notify Covered California that your income makes you eligible for Medi-Cal. Conversely, if you start the year in Medi-Cal, you won't be switched to CC unless you report higher income to Covered California.

How to Send Verification Documents?

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Question: Where do I send covered ca requested verification documents?

Answer: Send your documents in one of these three ways:
• Online using your account at www.CoveredCA.com
• By fax to 1-888-329-3700 (1-888-FAX-3700)
• By mail to:

Covered California
PO BOX 989725
West Sacramento, CA 95798-9725

Do You Need Financial Assistance?

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Question: One of the first questions asked in Cover California website is that "Do you need financial assistance?". If I answer "no" for now and it turns out that I'm qualify for assistance when I do my 2015 tax a year from now. Would I still be able to get premium tax credit?

Answer: Yes. If you answer no th the question, "Do You Need Financial Assistance?", your Covered California account still include your tax information and you will be able to claim a tax credit later. However, if you enroll off-exchange, you cannot later claim tax credits.

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