Question: I am a 63 year old, long time Kaiser individual-pay member, and wish to stay on Kaiser, but I will be classified as Medi-Cal eligible due to not working for 2 years. Since I won’t be eligible for a premium subsidy in the Marketplace, will Kaiser offer a similar plan for Medi-Cal individuals? If so, will it have comparable coverage and co-pays? I did read your posts at Feb. 20th, 2013 9:54 AM and also Feb. 4th, 2013 2:46 PM, but they seem to contradict each other suggesting that if I was Medi-Cal eligible I’d have to pay full fare if I wanted to be covered in the Marketplace. Yet on Feb 4 you seem to indicate I could stick with Kaiser in some plan. Lots of us low income Kaiser members who will want to know the precise answer to this. Other wise, not wanting to leave Kaiser, we’ll be paying full fare without even getting a subsidy that moderate income people get. BTW, You have a great site with wonderful questions and answers to so many of the questions that affect us. If I call Kaiser, they seem to know nothing.
Answer: You are correct. If your income makes you eligible for Medi-Cal (less than 138% FPL), you cannot opt for subsidized coverage in Covered California. However you can choose a Kaiser plan inside the Exchange or directly from Kaiser without premium subsidy or cost sharing assistance. Kaiser coverage in 2014 be more comprehensive on the whole than todays plans due to ACA requirements. Unfortunately, the cost of coverage will be higher as well. Hang in there. You’ll be on Medicare soon.