Q&A: 7 On Your Side answered your Covered California questions
SAN FRANCISCO (KGO) -- The deadline to enroll in Covered California for the year is at the end of this month. 7 On Your Side's Michael Finney and a team of experts hosted a hotline on Friday, where they answered all your Covered California questions.
Click here for more stories about Covered California.
Below are the answers to your Covered California questions:
Question:
How do I know if I'm eligible?
Answer:
You can use our Shop and Compare tool to determine if you're eligible for a plan through Covered California or Medi-Cal.
Question:
Jackson S. asked via email: I'm enrolled in Covered California. What happens to my coverage if Congress eliminates the Affordable Care Act?
Answer:
Covered California rates, coverage and financial help will remain intact for 2017. We will keep our members informed if any changes occur in the future.
Question:
Alma asked via email: Does Covered act as a secondary coverage for a person getting Medicare because of disability?
Answer:
No. For Medicare questions, we recommend contacting HICAP, which provides Medicare consulting at no cost. They have offices in every county of California. Click here for more information.
Question:
Susan asked via email: I have $850/month income from a retirement plan. Do I qualify for Covered California?
Answer:
Residents of California can enroll here regardless of income. Your income only affects whether you are eligible for tax credits and, if so, how much those tax credits are. You can very quickly get an estimate of what tax credits you may be eligible for by clicking here.
Question:
I am writing this email for my client Miss K. She received letters from IRS demanding that she has to pay back the health insurance premium assistance from Covered CA. I and Miss K have tried to resolve the issue for 6 months. Miss K and I contacted Covered CA several times and in they told us that they have transmit information to IRS about the mistake. However, IRS continue to send Miss K billing invoice asking for payment. Miss K will greatly appreciate it if you can help her to resolve the issue. It is very likely that there are others who got his/her health insurance from Covered CA that ran into the same situation.
Answer:
Please contact Covered California's Ombudsman, Darryl Lewis at (916) 228-8327, darryl.lewis@covered.ca.gov. Here's some additional information relating to the IRS. When you enroll on Covered California's website, you need to estimate your income for the coming year. After the end of the year, you put your actual income on the tax return you send to the IRS. If your actual income is less than what you projected, you may be eligible to get additional tax credits back from the IRS. On the other hand, if your actual income exceeds what you projected, you may need to pay some of those tax credits back to the IRS.
Question:
Do adults have dental coverage through Covered California?
Answer:
Covered California now offers option to add adult dental coverage for an additional cost when enrolling in a health plan. For more information, click here.
Question:
Renee R. asked on Facebook: Would CC help with cost of my health insurance through work? They cover me but not my dependents.
Answer:
Generally, no. Most employer-provided coverage of the employee is subsidized enough such that it precludes the employee's family (spouse and children) from being eligible for any tax credits, even if the employer does not extend that subsidy to the employee's dependents. In some counties, such as San Mateo County, residents caught in this dilemma may be eligible for a county health program.
Question:
Eleanor M called our hotline asking: I got laid off early last year. I currently have Cobra coverage. I got a job after I got laid off, but it was only a temporary one. Cobra is expensive for me since I don't have a job now. I'd like to find a cheaper health coverage option. I have a couple of questions: May I know if Covered California can help me find a cheaper health coverage? WHat income would I report - the one for the whole year of 2016?
Answer:
Yes, it would be prudent for you to shop for cheaper Covered California health plans. You can use our Shop & Compare tool to look for the best value by clicking here. For your second question, if you are talking about enrolling in coverage for 2017, you need to report your projected income for the total year for 2017.
Question:
Myhanh called our hotline asking: If I were to quit my job later on this year, would I be able to sign up after my work coverage ends?
Answer:
Yes, you would have 60 days from the loss of employment to enroll in a health plan through Covered California's Special Enrollment process.
Question:
John called our hotline asking: My ex-spouse has our children enrolled with Covered CA. I just got a new job and would like to move our children to my plan because it is more affordable and offers better medical options. Does a new job qualify as an acceptable reason to cancel my children's coverage with Covered CA?
Answer:
I'm assuming the children are dependents of yours. If the employer lets you enroll them, you can enroll them. You can cancel Covered California coverage at any time, although you will have to cancel several weeks before the end of the month in order for coverage to end at the end of the current month. But we strongly recommend not canceling your coverage unless you are starting other coverage, such as employer-provided coverage.
Question:
Cathy asked via email: My kids qualified for the CCHIP program of San Mateo but I don't like it. We have had Kaiser for over 17 years, but if we decline the CCHIP program they will into get subsidized help and will have to pay the full price for Kaiser. What can I do?
Answer:
Please call the San Mateo County Health Coverage Unit at 650-616-2002.
Question:
Nancy L. asked via email: Can Covered California survive without federal funding? Should Congress kill Obamacare?
Answer:
Covered California rates, coverage and financial help will remain intact for 2017. We will keep our members informed if any changes occur in the future.
Question:
Gayle G asked on Facebook: What happens if you made more money than you signed up for?
Answer:
When you enroll at coveredca.com, you need to estimate your income for the coming year. After the end of the year, you put your actual income on the tax return you send to the IRS. If your actual income is less than what you projected, you may be eligible to get additional tax credits back from the IRS. On the other hand, if your actual income exceeds what you projected, you may need to pay some of those tax credits back to the IRS.
Question:
Marian G asked on Facebook: Will our coverage last after Trump in inaugurated?
Answer:
Covered CA rates, coverage, and financial help will remain intact for 2017. They will keep their members informed if any changes occur in the future.
Question:
Joe asked via email: I was laid off but have medical/dental coverage until March 31 of this year with a Cobra option. I would like to enroll in CC but can I enroll in January for coverage to begin April 1 or must I wait until March?
Answer:
You may be able to enroll now and specify the coverage to start April 1st. However, note that by default, the coverage will start as soon as possible, so look carefully to make sure you specify April 1st. If you enrolled tonight (January 13), by default the coverage should begin February 1st.
Question:
Jane D asked via email: My son will be turning 26 in May and is currently on my policy. Can he enroll in May and does he need to have proof of current medical insurance? When and what doe she need to do to enroll?
Answer:
Yes, your son can enroll in Covered California as soon as he turns 26 through Covered California's special enrollment process. He can enroll online here, call the Service Center at 1-800-300-1506, or connect with a local certified insurance expert here. Agents will be able to assist you in finding a plan that best meets your needs. Their services are free and they are trained and registered to provide in-person assistance to consumers applying for Covered CA health plans.
Question:
Alyse A asked via Twitter: I will be losing my employers' insurance starting in April. Should I enroll now or can I enroll after my insurance loss?
Answer:
You can qualify to immediately enroll in Covered California health plan after you lose your health insurance through Covered California's Special Enrollment process. You have 60 days from the date you lose your insurance to enroll in a Covered California health plan.
Question:
SlimerDude asked via Twitter: My wife was enrolled in 2016. There are no lifestyle changes, i.e., income, expenses, etc. Does she need to renew? Thanks!
Answer:
In some cases you may be able to auto-renew. But i recommend calling coveredca.com at 800-300-1506 to confirm what, if anything, she is currently enrolled for in 2017. It's a good idea to shop and compare every year, as you may be able to get a better deal by switching to a different insurer.
Question:
Yoko N asked via Twitter: Is Medi-cal the default insurance for people earning $25,000 annually? Can you apply for private insurance like Blue Shield?
Answer:
I recommend going here to see what you are eligible for. Generally, a single adult making around $16,000 or below would be eligible for Medi-Cal.
Question:
Elizabeth asked via email: I was unemployed and had Medi Cal, but I never once went in for a physical or a check up. I have been working part-time for Target for the past year. I got a letter from Covered California telling me I need to apply for a health plan. I don't feel I make enough to afford a plan. I do need Dental work and I would like to get a physical. I did get online to look up for a list of health providers, but I don't really know what to do next.
Answer:
First, I recommend going to our Shop & Compare page to see what tax credits, if any, you are eligible for. You may choose to work with a local enrollment counselor, which you can find here. Or you can enroll yourself online here. Even if you do not have enough income to qualify for a Covered California plan, you can qualify for a no-cost or low-cost Medi-Cal plan. Medi-Cal covers low-income adults, families with children, seniors, persons with disabilities, children in foster care as well as former foster youth up to age 26, and pregnant women. Learn more here.
Question:
Ray asked via email: My friend just moved to California, does not have an ID yet, but is working in San Francisco as a server and lives in San Mateo County. Do you recommend that he sign up for Covered California or apply to Healthy SF? I'm sure he would want better coverage.
Answer:
Only SF residents are eligible for Healthy SF. To check out Covered California, I recommend he go to here to find out what coverage and tax credits he may be eligible for. Since your friend is a resident of San Mateo County, it might be helpful for him to call the San Mateo County Health Coverage Unit at 650-616-2002. Regardless of their immigration status, San Mateo County residents can access free or low-cost health insurance coverage, through a combination of federal, state and county programs. The County is committed to the privacy and security of all personal information, as required by law.
Question:
Monique P asked: I'm changing jobs and need health coverage.
Answer:
Through Covered California's Special Enrollment process, you can qualify to enroll in Covered California within 60 days of the loss of your job. In order to get started the first step is to go to our Shop and Compare. Enter some information about yourself to get a quick estimate of what you would pay for health insurance and which plans are available in your area, and to find out if you qualify for financial help. The second step is to call our Service Center at 1-800-300-1506, or connect with a local Certified Insurance Expert here. Agents will be able to assist you in finding a plan that best meets your needs. Their services are free and they are trained and registered to provide in-person assistance to consumers applying for Covered CA health plans.
Question:
Gayle G asked on Facebook: If you are eligible for Medicare in May, should you still sign up for CC?
Answer:
Yes. You can start the Medicare enrollment process three months before eligibility. But if the Medicare coverage will start May 1 (it should start the first day of the month of your 65th birthday), then you will want to enroll in Covered California January through April, and contact Covered California to cancel that coverage in early April. To sort through the Medicare enrollment process and your choices, I recommend contacting HICAP, which provides Medicare consulting at no cost.
Question:
Sharon G asked via Twitter: Just started a new job and have a choice of insurance for $1k/month with Blue Cross. Can I choose Covered CA? What if it's repealed?
Answer:
I assume you mean the $1K/month Blue Cross plan is employer-provided coverage, and it only covers you. You can instead enroll in Covered California, but if the employer-provided coverage is considered "affordable," you would not be eligible for any tax credits. Employer-provided coverage is considered affordable if your portion of the premium is less than 9.69% of your modified adjusted gross income, and the coverage satisfies certain criteria. I recommend calling Covered California at 800-300-1506 to review the issues.
Question:
Jean-Paul A asked via email: I'm turning 26 years old and need to find my own health insurance. How do I find a good an affordable health insurance plan?
Answer:
You have 60 days to enroll in a Covered California health plan after you turn 26-years-old through Covered California Special Enrollment process. In order to get started the first step is to go to our Shop and Compare here. Enter some information about yourself to get a quick estimate of what you would pay for health insurance and which plans are available in your area, and to find out if you qualify for financial help. The second step is to call our Service Center at 1-800-300-1506, or connect with a local Certified Insurance Expert here. Agents will be able to assist you in finding a plan that best meets your needs. Their services are free and they are trained and registered to provide in-person assistance to consumers applying for Covered CA health plans.
Question:
Joan asked via email: My daughter's premium doubled. What is the premium based on?
Answer:
First, to be clear, there is the premium you would pay if you are not eligible for any tax credits. That premium depends on where you live (there are I believe 19 different pricing regions within California), your age, the insurer you select, and the metal tier you select (Bronze/Silver/Gold/Platinum). But if you are eligible for tax credits, the effective amount you would pay is less. The tax credits are based on your family size, your modified adjusted gross income, and the second lowest cost silver plan in your area. If you are eligible for tax credits, it should bring the portion of the premium you pay down to no more than 9.69% of your modified adjusted gross income, and possibly lower. Under certain circumstances a premium could jump significantly if your income goes up and you had been paying much less than 9.69% of your income. Remember also that premiums go up with age.
Question:
Patti asked via via email: I have a relative that is unemployed and is covered by Medical (by Covered California). If the ACA is repealed (and not replaced immediately), will Medical coverage drop those who are covered currently because they have no income?
Answer:
You might want to call the Medi-Cal in the relative's county. You can get more info on that here. But as far as Covered California is concerned, rates, coverage and financial help will remain intact for 2017. We will keep our members informed if any changes occur in the future.
Question:
iceman600 asked on Twitter: An undocumented friend is asking if she can enroll for Covered CA.
Answer:
Under the Affordable Care Act, most individuals who are U.S. citizens, U.S. nationals or lawfully present immigrants are required to have health coverage. Immigrants who are not lawfully present are not eligible to purchase a health plan through Covered California; however, they may be eligible for coverage through Medi-Cal or county programs. Both lawfully present and not lawfully present individuals can apply through Covered California to see if they are eligible for health plan options through Covered California or Medi-Cal. Learn more here.
Question:
Kathleen W asked via email: Can my 83-year-old mother use Covered California for her supplemental insurance to medicare? She presently pays $384.00 a month for coverage. She legally doesn't have to file income tax because she is below the threshold for income.
Answer:
Sorry but no. If you are eligible for Medicare Part A at no cost, you are not eligible for Covered California.
Question:
Marie asked via email: I have an inconsistent salary but also if I need to, I have to cash out stock or sell to maintain and pay bills on lower income months. Is that considered income with Covered California? When I do my taxes I have to put them on my taxes as income. Will that change my health coverage plan amount?
Answer:
If you sell stock in a taxable account (i.e. not an IRA account), that could generate capital gains which gets counted on your tax return. Taking a distribution from a traditional IRA account also counts as income. So, yes, that can affect how much in tax credits you are eligible for.
Question:
Brian H. asked via email: Due to an accident, I am unable to eat properly due to missing teeth. I need to put my health money toward dental first, and it is cheaper if I pay directly, leaving me with not enough money to pay for anything else due to my recent homelessness. Is there any exemption so I can finish my dental work before being required to pay a health policy? Last year, both the state and feds emptied my account and I was unable to keep up with the payments through Kaiser. I need to fix teeth and eat first. I do not have enough to cover both at this time. Will I be fined?
Answer:
If you don't have health coverage, you may have to pay a fine. But I recommend checking out our Shop & Compare here to see what coverage options you have and how much they would cost. If the accident is preventing you from working, chances are your income is lower and you may be eligible for health coverage at no or low cost. Also, agencies that assist the homeless, such as lifemoves.org (San Mateo and Santa Clara counties) may have enrollment counselors that can help you sort through your options. Best wishes for your recovery.
Question:
Jack R. asked via email: My daughter has been trying to sign up for Covered CA but her identity cannot be verified online. We faxed her drivers license and Social Security card per the instructions and even went to the Contra Costa County Health Dept to try in person, and they uploaded her info as well, but she still shows she need Identity Verification before she can proceed. We've been trying for over a month to get her signed up. Do you have any other ideas to get her identity verified?
Answer:
Since your daughter has already tried to correct this matter online and in person, perhaps you should contact the Covered California Ombudsman, Darryl Lewis at darryl.lewis@covered.ca.gov or (916) 228-8327,who may be able to trouble-shoot the matter for your daughter and get it resolved.
