Wednesday, January 15, 2014

Medi-Cal? Really??? But...but...but...

I've had at least a half-dozen phone calls over the last week from people whose children ended up involuntary enrolled in Medi-Cal.  They weren't happy.   And, like the similar situation Henry posted recently, Medi-Cal bears an annoying resemblance to the Roach can check in, but you can't check out.

The problem stems from different and very liberal qualification levels for children.  In this area, a typical family of four has to have a Modified Adjusted Gross Income (MAGI) of over $62,643 before the kids are allowed onto a regular insurance plan.   For the adults to qualify, the MAGI has to be below $32,499.  There are an awful lot of families sitting between the thresholds.

As far as I know, the only way around it is to go outside the exchange, forgo the Advance Premium Tax Credit (a.k.a. the revokable subsidy) and pay full freight for separate policies for the children.   I'm not sure, though, if having a mixture of policies inside a family - Exchange plans for the adults and Off-Exchange plans for the kids - impacts APTC eligibility for the adults.  Any other suggestions?

Household Size MAGI
Medi-Cal Threshold
Medi-Cal/CHIP Threshold
138% Fed Poverty Lvl 266% Fed Poverty Lvl
1 $15,856 $30,563
2 $21,403 $41,256
3 $26,951 $51,949
4 $32,499 $62,643
5 $38.406 $73,336
6 $43,594 $84,029
7 $49,141 $94,722
8 $54,689 $105,415
Each Additional $5,547 $10,693
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