Californians are receiving their renewal rates for 2017 and are surprised by the steep increases in health insurance. Covered California offers subsidies if your modified adjusted gross income falls below the 400 % Federal Poverty Level  (line item 38 on your 1040 tax form or line 22 of your 1040A form) .

For the year 2017, Covered California will base the subsidy on the Federal Poverty Level 2015 guidelines.

 

 

 

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Many Californians are overwhelmed by just looking at a chart like this. Did you know that we will help you to find health insurance for 20167for no extra charge on your premium as your agent? We can figure out how to get the subsidy you deserve and avoid unwanted services as your agent. Email us at info@solidhealthinsurance.com and we will make sure that we find you an affordable health plan in California.

COVERED CALIFORNIA ENHANCED SUBSIDY ELIGIBLE

The Enhanced Benefit on the Silver Plan are based on income and dependent status:

  • if your FPL is between 139% – 149 % ( for a single $16,243 -$17,655 ) you only pay 4 % of the monthly costs up to $58. 94% of costs are subsidized (your have$ 75 deductibles , $ 5.00 for doctor visits. specialist $8.00 – out of pocket maximum is $ 2350)
  • If your FPL is between 151% -200 % ( for a single $17,656- $ 23,450) you only pay 6.3% of the cost, monthly up to $ 123 . 87% of the cost is subsidized ( you have a $650 deductible, drug deductible $ 50  , $ 10 doctor visit , $ 25 specialist – your deductible is  OOP is $ 2350).
  • IF your FPL is between 201% -250 % ( for a single $ 23,451- 29,425 ) you pay 8.05% of the cost monthly up to $196, 73% of the cost is subsidized. You pay $30 for primary care visits, $55 for specialist , your deductible is $ 2200 , drug deductible   out of pocket is $ 5700).
  •  If your income is greater than 250% and less than 400% the subsidies are lower.

MEDICAL ELIGIBILTY:

For Californians whose modified adjusted gross income ( line item # 38 of 1040 – or line item 22 on 1040 A) is in the bracket of 100-138 % qualify for Medical and not Covered CA.
In “mixed” families who have a MAGI of 266% FPL or less, the minors will be eligible for Medical and not Covered CA. The parents will be eligible for Covered CA. We can explain to you how to avoid this.
Pregnant women who have a MAGI of 213% FPL or less qualify for Medical and not Covered CA, however in 2017 you will have the option to remain on Covered CA if you choose to elect Covered CA instead of Medical.
The Open Enrollment Period is from November 1st 2016 – January 31st, 2017. In this period all Health Plans will be GUARANTEED ISSUE. No medical underwriting is required, no pre-existing conditions, and no limits on coverage. All Health Plans will be standardized with” metal” plans that cover 10 Essential Health Benefits (whether inside or outside of the exchange).

Rates and provider networks will vary by insurance carriers. California has 19 rating areas. Blue Shield of California will be the only PPO carrier California wide,  Anthem will go back to an EPO system and will not have anymore any tiered hospital system, Oscar is expanding to the San Francisco region, Kaiser and Molina Care are also expanding in some California regions Rates will be calculated by region and by age of each family member. Children over the age of 21 are rated as adults.

Many Californians are overwhelmed by the task of figuring out the new affordable care acts and how to maximize the benefits for your family. As your agent, we can help. Email us at info@solidhealthinsurance.com or receive a free premium quote. We will make sure that we find you and your family an affordable health plan which fits your health and budget needs