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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.


Are Senior Immigrants Eligible for Subsidy?

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Question: Hi, I and my wife are new immigrants sponsored by my son in CA and our age is > 65. Our combined income is 3k. I have few questions. Can we file tax as "married filing jointly" as income 3K. If so, can we apply for tax credit/subsidy in coveredca for the premium and for cost sharing(deductible/out of pocket cost)vWe are 81 and 77, household size is 2. If our income is about 10K/year, what will be our premium and out of pocket costs, even if its an approximation?

Answer: Medicare would be your first choice, but I assume because you did not mention it that you do not meet the 5-year residency requirement. Based on your income ($3,000 to $10,000 annual), you are eligible for MediCal (not Covered California). Medi-Cal requires only that you reside in California legally.

3 Comments

Hi Phil. My clients have a Blue Shield plan with a healthy advance premium tax credit subsidy. When they initially enrolled through the CovCal (Cal-HEERS) application system, they were given Medi-Cal because their household income (MAGI) was under tax credit eligibility (therefore Medi-Cal eligible). After two months of Medi-Cal and waiting for enrollment, Medi-Cal sent them a letter saying they were ineligible for Medi-Cal, and further conversations with Medi-Cal stated this was due to their (legal) immigration status under five years in the U.S. Havoc ensued, clients had no health plan coverage at all. Many confused Covered California reps later, they re-set my client’s Cal-HEERS application and affirmed their eligibility for a private health plan with tax credit subsidy. How their advance tax credit is calculated, we have no clue, and of course no one at Covered California has any clue either (“the system does it,” they say), as my client’s income, per normal MAGI criteria, provides Medi-Cal eligibility. Covered California also forced their new Blue Shield policy effective date back retro two months, so my clients were also forced to pay three months of premium at once, for the current month of new coverage they obtained and for two months already gone by and for which they had no claims and had previously been informed of their enrolled Medi-Cal coverage. Last my clients and I spoke a few months ago they were on extension to file their taxes, so their tax credit had yet to be claimed. We do not know how to assess their exact tax credit for they to claim on their taxes and to reconcile with their previous monthly advances (APTC), and neither does Covered California. We hope their tax person does (yeah, right). Covered California could care less; their reps just want to provide answers they know. Sometimes a cognizant caring Covered California rep will attempt to find a worthy and legitimate answer to solve the problem of an issue, but they then are usually provided junk answers themselves and/or effectively told to tow the line.

Michael, when you said “wound up with coverage as described here” did you mean Medi-Cal coverage or CC coverage?

I have clients in the near exact situation. Actually, Medi-Cal will not provide coverage, as Medi-Cal says they are ineligible due to being immigrants (though with Green Cards). The CovCal enrollment application system is now supposed to recognize this scenario, and still determine Eligibility for enrollment into a health plan, and with tax credit subsidy. My clients’ process was less smooth, but wound up with coverage as described here.

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