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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.

Retirement Income and Premium Assistance?

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Question: I currently have private health insurance. I am looking at my options if I retire in 2015. My retirement AGI would be low enough to qualify for a subsidy under Covered Ca, and this may reduce my premiums by more than 50%. If I understand correctly, a low enough AGI might make me ineligible for this subsidy since I would qualify for Medi-Cal. Is this correct? What are the AGI thresholds for a single person in 2015? There seem to be many retirees in this same situation. They can afford to pay the subsidized plans, and they would rather not switch to Medi-Cal since it may not be accepted by their current doctor. Their options seem to be to either pay the full cost plan, or switch to Medi-Cal. Your thoughts?

Answer: Since many retirees can control their income through investment withdrawals etc, it make sense to know what the Medi-Cal income benchmark is. The Medi-Cal threshold is set at $138% of Federal Poverty Level (FPL). In 2015, that's $16,105.


I will be 65 next month and my wife is 64. I called CC agent for dropping my Covered California insurance plan because I just got approval for Medicare. So my wife will be the only one in this house still remain in the CC insurance plan. It is interesting that the agent told me the monthly premium has been increased for $12 dollars while I was expecting that the premium should be much less because the same insurance plan, same income, same number of household. I figured that Anthem did cut their gross premium 50% but the CC assistance amount cut almost 60% and it ends up that we have to pay more after I drop from the CC plan? It sounds funny that I would like to have both medicare and CC insurance to lower down my payment (but goverment will be paying hundreds more).

If I qualify for Medi Cal because of my low income, but have a lot of assets, will I have to pay back, out of my estate what I used in medi cal benefits?

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