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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.


Elderly Resident Coverage?

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Question: My mum recently immigrated her, she is 79, and we currently have coverage until end of year through travel. She is a legal California Resident and I wish to apply for covered CA for her. She lives with me, but her income individually is low, at a pension of around $1000 per month. What are the steps to take. Thanks.

Answer: Your mother does not qualify for public health insurance, either Medicare or Medi-Cal. Since she is a legal resident, she does qualify for Covered California coverage regardless of her age. She may be eligible for premium assistance as well. She can apply during open enrollment starting October 1 for coverage effective January 1, 2014.

3 Comments

To the original poster’s questions.

“She is a legal California Resident and I wish to apply for covered CA for her. She lives with me, but her income individually is low, at a pension of around $1000 per month.”

I have been told by a Covered California supervisor that the individual must have a “Green Card” in order to sign up and get a subsidy. I mention that because some come here legally and intend to stay, but don’t yet have their Green Card.

Also, you mention that your mother’s income is $1,000 per month and that she lives with you. As I understand it, your mother’s income will be included with your entire household income for purposes of calculating any tax credit (subsidy) for her Covered California policy. See the CoveredCA site and use their calculator.

I got a clarification of this issue of Social Security Tax credits that seems to be true.

It is not just that you are eligible for Medicare, but rather if you are eligible for Medicare subsidies. As follows.
If you have 0 to 29 credits, you get no subsidy for Medicare Part “A”. You pay $441. If you have 30 to 39 credits you get a $198 subsidy and pay only $243 If you have 40 or more credits you pay ZERO, thus you’ve been given a $441 subsidy.

So, only the person with 0 to 29 credits is NOT getting a subsidy. Thus, only that person is entitled to join Covered California AND still be entitled to a tax credit (subsidy) to pay for their Covered California policy.

A person in the 30 to 39 credit range would be in a poor position. They will end up paying much more for Medicare than for Covered California. They will pay $243 for Part A, plus $105 for part B and perhaps another $125 to Kaiser for a supplemental plan. $473 in total.

That same person, if low income, could get a Covered California subsidized policy for as little as $44 a month.

Seems unfair, especially when a person, 65, newly arrived in the country, might get that subsidized Covered California policy because they are not eligible for Medicare for 5 years.

Back in November you said “Individuals are not eligible for tax credits if they are eligible for Medicare” What does “eligible” mean? Is every American citizen, age 65+, “eligible” for Medicare, thus not eligible for tax credits? Three examples. 1. Age 65+, never worked. 2. Age 65+ earned 1-29 credits. 3. Age 65+ earned 30-39 credits. 4. Age 65+ earned 40 credits. A low income newly arrived non-citizen, age 65+, might get a tax credit, while a lifelong citizen, age 65+ might be denied that same credit on Covered California, even though he/she would have to pay the full Medicare Part A cost of $441 a month to join Medicare (plus $105 for Part B) Covered California’s 800 line wasn’t sure about the definition of “eligible” for Medicare.We could have the citizen paying $546 a month and the newly arrived non-citizen paying as little as $46 a month for Covered California.

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