Thursday, November 14, 2013

Obamacare Fun

All the people having their private health insurance cancelled because of Obamacare has been in the news lately. Guess what? They're kinda dumping those on government health programs, too.

Got a letter from the state yesterday advising me that, because of the new Affordable Care Act, they'll be terminating most County Medical Services Program (CMSP) members by December 31. They advise checking Obamacare's Covered California web site, or MediCal, to see if I'm eligible for either of those.

CMSP, as best I understand it, is pretty much a county run program similar to MediCal. What the difference might be in this regard, I don't know. I pay share of cost under CMSP. That means I pay the first $650.00 or so of my medical expenses each month. I have no idea how that would work if I qualified for MediCal.

Am I qualified for MediCal? I don't know. I've already checked the Covered California web site. Depending on what annual income I declare- plus or minus a thousand dollars- I was either unable to apply for the Obamacare plan because I might be eligible for MediCal, or the Obamacare option would cost $400 a month. Maybe more.

What the outcome with this might be, it's too early to tell. It could turn out ok, or it could be awful.

It is funny to see Obamacare booting people from even government health programs. It might even be funny if I end up not having any coverage at all because of Obamacare. I don't know that I'll be laughing along with everybody else.


At 10:06 AM, Anonymous Anonymous said...

Can you read Fred? Do you listen to the radio? If you get CMSP you qualify for ACA medi-cal. And it will be better for you than CMSP. You are so dumb it is kind of embarassing .

At 10:08 AM, Blogger Fred Mangels said...

That remains to be seen. I hope you're right.

At 11:26 AM, Anonymous Anonymous said...

So Mr. Libertarian is all butt-hurt that he might lose his government-subsidized healthcare and have to purchase private insurance through the exchange? Irony abounds.

At 12:02 PM, Anonymous Poster formerly known as Matt said...

Hopefully it works out ok. You might try calling the Covered California people. I think there's supposed to be some organization locally to help go over everything with you but I'm not sure who they are. Maybe try calling the local United Way because they were working on it. They can probably put you in touch with the right people.

At 1:30 PM, Blogger Fred Mangels said...

You might try calling the Covered California people.

I've already been to their web site. It was a little unclear as to where I stand as I'm right on the borderline of being MediCal qualified.

I'll likely just wait until the end of December and see if I get any sort of application from whomever. Kinda hard to believe they'll just shut everything off without some additional information.

The thing I got in the mail is rather strange as it's more of a generic notice to probably tens of thousands of people. I can't help but think they'll send some sort of other paperwork out before January 1.

At 1:31 PM, Blogger Fred Mangels said...

I might add that I'm pretty sure the applications for CMSP and MediCal are the same, and processed by the same people. That's why I would think they'll still send an application out?

At 2:29 PM, Anonymous Anonymous said...

So now the Proud Libertarian is going to wait around passively, hoping that the government will send him an application? Jeez.

You can apply for MediCal in about 15 minutes at:

You set up an account with a password, answer some questions, review your answers, see if you would qualify, and if so, send it off. If you're not qualified for MediCal, but you're close, you will definitely qualify for heavily-subsidized private coverage through Covered California.

By the way, if you're right at the line between MediCal eligibility and subsidized private insurance through Covered California, your premium (after the subsidy) should be quite a bit lower than $400/month. Well, maybe it could be that high for the "Platinum" plan, I didn't look at that...but then again I don't expect the government to serve me subsidized health insurance on a Platinum Platter. Nor would I wait around hoping they'll spoon-feed it to me.

At 5:42 PM, Blogger Fred Mangels said...

So now the Proud Libertarian is going to wait around passively, hoping that the government will send him an application?

Uh, huh. And you can go fuck yourself, but thanx for the link.

At 6:42 PM, Anonymous Anonymous said...

A bit sensitive there, sport?

Look, I just pointed out that your passive I'll-wait-and-see-of-someone-sends-me-a-form approach is a bit ridiculous, given how easy it would be to determine if you were eligible for MediCal if you just took a little bit of initiative.

But hey, if you'd rather wait around in the hopes that maybe a MediCal application will show up in your mailbox, feel free. If it doesn't come and you end up uninsured and paying a penalty for being uninsured, then I guess you can write another blog post complaining about how you ended up uninsured "because of Obamacare." To me that seems like either extreme ignorance/laziness, or else amounts to cutting off your nose to spite your face. But hey, that's up to you. I provided the link for MediCal (which, by the way, you could have found yourself with a quick Google search) and you already have the link for Covered California -- so if you're unwilling to spend a few minutes to sign up for insurance, that's on you.

In the meantime, rock on with yo bad Libertarian self!

At 6:40 AM, Blogger Fred Mangels said...

Checking that link, I've already been there. I read on my last CMSP/MediCal application you could apply online and they gave that web site address. I started to go through it but some parts were confusing as it seemed to be designed for new applicants, not current members.

I called the 800 number and spoke to a worker. He recommended not using the web site as it was meant for new applicants and already being a "member" might mess things up.

At 11:25 AM, Anonymous Anonymous said...

Hmmm. So what did the worker suggest?

And was this conversation recent, or was it the last time you applied, before CMSP was discontinued?

At 12:57 PM, Blogger Fred Mangels said...

He just said to fill out the paper application I already had. This was in August(?) or thereabouts. My guess would be they'll be sending out another paper application to current CMSP people, but if they fill them out and don't qualify for MediCal they'll just be told they don't qualify. If they qualify, I suspect they'll just be enrolled in MediCal. Just my guess.

The application is pretty much the same for both MediCal and CMSP. The wife's MediCare/ MediCal application is the same one I get and gets sent back to the same address.

That's why it would surprise me if they don't send at least one more application out. If I don't get something in the mail by the first week of December, though, I will call in and ask about it. I should be due for another eligibility thing about now, unless I'm mistaken.

At 4:59 PM, Anonymous Anonymous said...

I'm not so sure you're going to automatically get a MediCal application in the mail just because you have been on CMSP. It sounds like they've already notified you that CMSP is ending and that your options are either MediCal or Covered California, depending on your income. If, in that notice, they provided you with a website and/or phone number, I would assume that you are supposed to go on the website, or call the phone number, and find out which one you are eligible for.

While this may be a bit more work on your end, it may make a whole lot more sense from the other end -- as opposed to the state or county sending all former CMSP users a paper MediCal application by snail mail, waiting for them to be mailed back, and wasting time entering data and processing forms for those who aren't eligible and notifying those people that they didn't qualify, and only then sending them over to the Covered California website. True, for those who did turn out to qualify for MediCal, this would be the easiest and most seemless transition, but for those who didn't, it would be a waste of time, not to mention taxpayer money.

If, as someone claimed in the comments above, ALL CMSP users were automatically eligible for the newly-expanded MediCal, then that blanket approach would make a lot of sense. But apparently that is not the case -- current CMSP users at the low end of the income scale will now be eligible for MediCal, while those with somewhat higher incomes will be eligible for subsidized private policies through Covered California. It may simply be that it is your responsibility to find out which group you belong in. This should not be difficult, as it appears to be a simple formula of household size and annual income (see chart below).

In any event, if I were you I wouldn't wait. If I understand correctly, your CMSP coverage expires on Dec. 31st. I believe you need to be either enrolled in a Covered California plan by Dec 15th, or enrolled in MediCal, in order for your coverage to take effect by Jan 1st (that way you don't leave yourself uninsured after your CMSP coverage ends Dec 31st).

So my advice would be to just go ahead and take a look at the chart below, confirm whether you appear to qualify for MediCal, and if so go ahead and apply (through the c4yourself website, or on the phone or in person at County Social Services). If it appears that you are not qualified for MediCal, then go ahead and choose a plan through Covered California. Why wait two more weeks for a form that may or may not arrive in the mail in the meantime?

Here are the new income limits for MediCal, depending on how many people in the household:

1 person $0 - $15,856
2 people $0 - $21,404
3 people $0 - $26,951
4 people $0 - $32,499
5 people $0 - $38,047

If your income is above those MediCal guidelines, but below $45,960 (that's for a single person household, it's higher if you have dependents), then you are eligible for subsidized premiums on a Covered California plan. The subsidies are calculated on a sliding scale --the closer you are to the bottom of the scale, the higher your subsidies are.

It seems to me that in your situation (at or close to MediCal eligibility) the only way you, personally, could end up worse off under the new system than the old would be if you delay too long, allow yourself to go uninsured, become liable for the tax penalty, and, more importantly, potentially get hit with big medical bills due to a serious injury or illness while uninsured. But there is no reason to let that happen.

FYI, I got those MediCal eligibility numbers from this helpful factsheet that San Luis Obispo County created:

At 7:25 PM, Anonymous Anonymous said...

Oh, so it turns out that you can apply for MediCal directly through the Covered California website (as opposed to using the "c4yourself" website, which can be more confusing because it's designed to let people sign up for food stamps and cash aid as well, and therefore has a bunch of questions you don't really need to answer to apply for MediCal).

I missed that the first couple of times that I looked at Covered California, because I was just looking at the "Preview Plans" function. Once you use the "Apply" function and set up an account and really start going through the application steps, it will take you all the way through the MediCal application process, if that's what it turns out you're eligible for.

Just to see what it would take, I went through all the steps right up to the end, except for the final step of submitting it. It took 10 minutes, and that included the time it took to upload a scanned copy of page 1 of my 2012 tax return to confirm my income, and a scanned copy of my driver's license to confirm CA residency. (If you don't already have a scanned copy of those on your computer, it might take 5 or 10 more minutes to do that, if you have a scanner. Otherwise you'll have to mail those in, or do it at the Social Services office.)

But seriously, that was easy. Of course since it's MediCal, it's just the one plan, no choices to be made like if you're choosing among the private (but subsidized) plans on the Exchange. So that will probably take a little longer, as you're going to want to compare plans, see which doctors are included within each plan's network, etc. I can't see it taking more than an hour, though, as there really aren't all that many plans on offer in our area.

At the income level I was looking at (just above MediCal eligibility) there are basically two companies, Anthem Blue Cross (for-profit) and Blue Shield of California (non-profit), and then of course both had Bronze, Silver, Gold and Platinum plans.

Hint: The Bronze plans are nearly free at that income level (with the subsidies) but have very high deductibles and co-pays, whereas for a very modest additional amount of premium, you can get a Silver plan with MUCH lower deductibles and co-pays.

Hint2: Blue Shield of California has a WAY better tool for looking up who is in their preferred provider network. Looks like PLENTY of local docs of all kinds of specialties, nearly all of them listed as "accepting new patients." Hard to make a direct comparison with Anthem/Blue Shield, because of the latter's crappy format for looking up docs. The Blue Shield of California's "Silver" plan costs a couple of bucks a month more than the Anthem/Blue Cross "Silver" plan, but from what I was able to glean, it looks like Blue Shield of CA has the better provider network locally. Which could mean less need to go "out of network," which is important because you pay more when you do.

Of course if you're happy with your current health providers, it probably makes sense to just see which network they're in, and go with that. That way you won't have to change doctors.

Good luck.

P.S. It would be cool to see a follow-up on this, as far as where you end up, MediCal or one of the private plans, and if the latter, which one you picked and why.

At 6:51 AM, Blogger Fred Mangels said...

Last time I tried the Covered CA website (shortly after Obamacare started) I never saw any way to apply for MediCal, but I didn't go as far as you did. All I got was a notice that I might be eligible for MediCal and thus wouldn't be eligible for Obamacare if I was.

At 11:35 AM, Anonymous Anonymous said...

Yes, I had the same experience, that's as far as you get when you start with the "Preview Plans" function. But if you go back and start with the "Apply" function it will take you all the way through, and after you get to a certain point it will either tell you that you're eligible for MediCal and you'll continue in that direction, or it will tell you that you're eligible for the private plans through the exchange and it will continue in that direction. So applying online through the Covered California website is definitely an option, if you want to do it that way. Or you can just get a paper application and apply for MediCal by mail or in person at Social Services. Either way will work.

At 12:01 PM, Blogger Fred Mangels said...

I think I'll call them Monday or Tuesday and ask. They already have most of my information. Would save some hassle if they just do it through the application procedure we've been using, but maybe that's not what they have in mind?

At 3:31 PM, Anonymous Anonymous said...

Calling early next week makes good sense to me. Maybe there is a way they can use the info they already have on file for you, but my guess is probably not. You're being signed up for a different program, plus although in your case none of your info may have changed, in general lots of people's info does change over time (people move, household members change, income changes, phone numbers and e-mail addresses change, etc) so they'd have to confirm all that info anyway.

Fortunately, signing up "from scratch" is just not very hard to do. The website is probably the quickest and easiest way for most people, but there's nothing wrong with doing it by mail or in person if that's easier for you -- as long as you don't wait until the last minute, and then encounter some unforseen delay. The processing time is normally pretty quick, but with a deadline looming there could be a surge of applications, and therefore a delay in processing them. So I think the idea of getting the process rolling early next week is a wise one.

My prediction is it will work out fine, it will take at most an hour or so of your time, and you're going to wind in much better shape health-insurance-wise than you were under CMSP.

At 3:40 PM, Anonymous Anonymous said...

By the way, I think you can pick up and drop off a paper application at any of the clinics that are part of the Open Door Clinic network, and I think you can also get advice/assistance there. Which might be quicker than doing it by mail, and more pleasant than a trip to the Social Services office. So if you're leaning toward applying on paper / in person, you might want to look into that option.

At 5:38 PM, Blogger Fred Mangels said...

I'm thinking they'll just send me one, as I get them at least 3 times a year. We'll see.

I usually drive down and turn in the application personally. They only give you a small envelope to return it in but it nearly always requires one of the big 8x1/2 by 11 ones.

At 6:21 PM, Anonymous Anonymous said...

Again, there's no real reason to wait and wonder, while there's a very good reason not to. But I feel like I'm starting to repeat myself.

In your previous comment you said you would probably call on Monday or Tuesday. That makes good sense. If they tell you they already sent you an application, or that they would be doing so shortly, and that you should be getting it in the mail shortly, well then, fine. Otherwise you have numerous options to sign up quickly and easily, as outlined above.


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