I have been hearing a lot of questions and concerns lately about MediCal and Covered
California income updates, so wanted to provide everyone with a brief overview of what some of
your obligations regarding income are when enrolled in either of these programs.
No matter what type of program or plan you are enrolled in, if the information listed in your
application changes, you are expected to report a change. Knowing when to report the change,
and which changes prompt or necessitate a change in health plan eligibility, is where it gets
tricky.
Your duties to report a change differ from program to program, and from one type of change to
the next. Address, family size, and Income updates are two types of changes I see often that
require immediate attention, and that often cause changes to plan type or program eligibility. If
you are enrolled in MediCal, it is your duty to report changes of this nature to the county within
10 days of the change. If you are enrolled in a Covered California plan, you are still required to
report the changes, but the deadline extends to within 30 days of the change. If you are
updating your income, and it moves you into a different income bracket based on household
size and income (calculated as %FPL, or percentage of the Federal Poverty Level), eligibility will
be determined based on the new information, and you will be forced to change plans or
programs. If you have moved below 138% FPL, you will be eligible for the MediCal program. If
you have moved above 138%FPL, you will be eligible for a subsidized Covered California plan.
MediCal does not have enrollment deadlines, or a special enrollment period like Covered
California does. If the change reported makes you MediCal eligible, the county may request
additional information. If your change makes you ineligible for MediCal, but eligible for a
Covered California plan, you will have what is referred to as a qualifying life event, as well as
specific deadline to enroll in a health plan. Working with an agent at Core Columbia Insurance is
always the best way to make sure you have met all of your obligations to the state and county,
and are receiving a plan that suits your individual needs, at the lowest price available.
As always, if you have questions or concerns, or would like to discuss a hypothetical situation,
or how any of this information pertains to your case, do not hesitate to reach out! We are here
year round to provide free assistance with these sorts of questions and concerns – give us a call
at 619-259-6905, or shoot us an email at info@corecolumbia.com.