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Covered California and Obamacare 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 Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

On the Line Between Covered California and Medi-Cal

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Question: If I am subsidized for healthcare through the exchange and then discover at the end of the year I qualified for Medicaid, what happens? My income varies year to year because I have 2 jobs. One pays monthy and the other is off and on throughout the year causing my income to vary between $15000 to $16000 a year. I can’t afford to pay at the end of the year so I’s rather over estimate. How is it handeled if they found out I should have went with Medicaid that year instead of subsidies?

Answer: Covered California is working on a “Bridge Plan” as a solution for situations like yours. The problem for people whose incomes place them on the line between Medi-Cal and Covered California subsidized coverage is continuity of care. If you and your family members are accustomed to medical care from a certain group of providers, a change from Medi-Cal to private coverage and back again will be disruptive at the very least, The proposed Bridge Plan will promote continuity of care and affordability by altering contracts with Medi-Cal Managed Care Plans to extend to families whose income is between 138% and 200% of FPL.


I thought I read somewhere that if your income changes during the year that you’re able to report the new income and receive the subsidies throughout the year, of course if they qualify, and if at the end of the year the income was less then they simply would have to repay back the tax credits given to that person thus helping the possible change in providers from happening in the scenario explained above. However if the income doesn’t increase as forseen the following year then I guess the bridge plan would come in handy for these people.

I think there should be a kind of like open enrollment period for these inbetweener once or twice a year to give a chance to be flexible during the current year for change like lose of job etc.

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