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Covered California Q&A

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.


February 2015 Archives


Medi-Cal Renewal Form?

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Question: The Medi-Cal renewal form says "every member of your household who is living with you or is listed on your tax return". I am married filing separately (for a few years now) and qualified for medi-cal for myself and 2 kids last year through Covered California. At that time i was not living with my husband. My questions is should i list my husband or not? We live with him now, but file taxes separately and do not have medi-cal with him.

Answer: Yes. His income is now a factor in your mutual eligibility, so if your household income is above $33k for 4-person household you and your spouse are no longer eligible for Medi-Cal and now eligible for Covered California coverage. But since you file taxes as "married filing separately", you are not eligible for premium assistance.


Question: We are a family of 4 however my daughter, age 23,who I covered under the Covered California family plan. She files her own taxes. Do I have to claim her and her income on my taxes?

Answer: No. If your 23 yr-old daughter files her own federal income taxes in 2015, she cannot be included as part of your household for CC eligibility. If she files fed income taxes for 2014 and you included her in your 2014 Covered California coverage, there is no penalty. However, you probably received excess advanced premium tax credits in 2014 which will be reconciled when you file your 2014 return. As for 2015, you have to remove her from your Covered California account and she needs to create a CC account of her own. She will be eligible for either Covered California coverage or MediCal based on her own income.


Question: My mother came in May 2013. Up to today, she has lived in the U.S. for 1.5 years. She just got her green card couple weeks ago. Can she qualify for Medicare as she never works in US or lives in US for 5 years? If she can't qualify for Medicare, can she get any healthcare plan with good medical coverage (> $1million)

Answer: Yes. You can enroll your 80-year-old mother in health insurance through Covered California even though she never worked in the US as long as she has legal residency in California. In fact, the only way to get her covered right now is through Covered Ca. She may be eligible for premium assistance otherwise the monthly cost will be pretty high as she will pay the monthly rate of a 64-year-old, the highest rate. Mom will be eligible for Medicare in 3.5 years, so she can use the Covered California coverage in the meantime. Longer term, she should apply for Medicare as soon as possible. Start at medicare.gov. She will have to pay for Medicare and cancel her Covered california coverage at that time.


Replace COBRA Now or Later?

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Question: If my COBRA coverage ends in July, do I have to enroll now or may I enroll in July?

Answer: You can enroll in Covered California by 2/15/15 and drop your COBRA effective 3/1/15 if it is advantageous for you. Otherwise, you can keep your COBRA coverage until it expires and apply for Covered California coverage then as you will be eligible for a special enrollment period at that time..


Kids in Medi-Cal Automatically?

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Question: I was told that if I have Covered CA health plan, my child is automatically enrolled in Medi-Cal. Is that true?

Answer: Not necessarily. It depends on the family income. If the household income is over 138% Federal Poverty Level (FPL) (approx. $33K for family of 4), but below 265% FPL (approx. $63K for family of 4), the children age 18 and younger are automatically enrolled in Medi-Cal. If the income is below 139% FPL, the parents are eligible for Medi-Cal as well. With income above 265% (and less than 400%) FPL, both the adults and children are eligible for Covered California coverage with premium assistance. If you or your children are eligible for Medi-Cal you can choose not to enroll, but you will not receive premium assistance.

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