Question: Our stated family income for a family of 5 was $80k for 2015 yet they sent us a letter that we all qualify for medi-cal. Letter says we can appeal but I see no way to do it on their website and cannot get through on the phones. Can't read secure mailbox due to some java issue. Advice?
Answer: If you already have Covered California coverage and your status was recently changed to Medi-Cal eligible, it's because the IRS has reported that your 2013 AGI was $38,000 or less. So if you can show that your current income is closer to $80,000, then you will be able to to get your status changed back to subsidy eligible private coverage. If you are applying for for Covered California coverage the first time and you reported your income at $80K and are found eligible for Medi-Cal, you've probably made an error on the application. The most common cause for this error is by entering an incorrect "end date" when entering your income. LEAVE THE END DATE BLANK. (How a casual user would know to do this is beyond me as we only learned through trial and error.) As for how to get through to Covered California, I have no sure-fire advice other than to avoid the busiest times - normal business hours. Try calling just after 8:00 AM or just before 8:00 PM. Good luck.
When it comes to entering income “dates” (first paid or last paid), my recommendation is leave BOTH BLANK. These are not required fields, and entering anything other than 1/1/2014 in the date first paid completely goofs up the income calculations.
Entering a future date, is worse, because it results in no calculated income.
I’ve communicated this information to the folks at CoveredCA, but they don’t expect a fix anytime soon.
I had a couple with your same income and the parents were put on a no subsidy plan and the children were put on Medi-Cal
I originally had trouble last year when I put my income in as annual amount. Technically it is since it is a IRA distribution I get once a year. It wasn’t until I converted it to a monthly amount that I could avoid Medi-Cal. Never would I have figured that out if it had not been for the kindness of a stranger on the internet.