Medicare
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Equitable relief for people with Medicare and Marketplace coverage
Individuals who have Medicare Part A coverage are considered to meet minimum coverage requirements under the Affordable Care Act and are therefore ineligible to receive premium and cost-sharing assistance for Marketplace health insurance plans. Individuals who have Medicare…
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Updated Specialty Thresholds for Medi-Cal Programs in 2018-2019
Effective July 1, 2018, through June 30, 2019, the FMBA amount for a family member living with the community spouse of an institutionalized spouse is $2,058 (compared to last year’s $2,030). DHCS ACWDL 18-13 (July 3, 2018); DHCS…
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Medi-Cal System Treatment of New Medicare Beneficiary Identifiers
The Centers for Medicare and Medicaid Services (CMS) is planning to phase in Medicare Beneficiary Identifiers (MBIs) between April 2018 and April 2019 to replace the current Medicare Health Insurance Claim Number (HICN) based on beneficiary Social Security…
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Updates to Medi-Cal Aged and Disabled, Medicare Savings Program Thresholds
DHCS has updated the thresholds for the the Medi-Cal Aged and Disabled Federal Poverty Level program. As of April 1, 2017, the monthly income limit for an individual is $1235 ($1005 + $230 disregard); the monthly income limit…
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DHCS 2017 FPL Charts
DHCS has updated its annual eligibility charts to reflect the 2017 federal poverty level ceilings for Medi-Cal and other health programs. The new FPLS are effective 1/1/17 for MAGI programs, 1/1/17 for MSP applicants and recipients without Title…
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Transitioning from MAGI Medi-Cal to Medicare
As of 8/1/16, CalHEERS has been able to verify Part A entitlement through the Federal Data Hub. Medicare entitlement precludes MAGI New Adult group eligibility, though it does not preclude eligibility through the MAGI Parent/Caretaker Relative or pregnancy…
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Medi-Cal Eligibility and the 2017 SSA COLA and Medicare Premiums
DHCS has issued guidance and provided resources on dealing with the 2017 SSA Cost of Living Adjustment (COLA) and the new Medicare premiums. In 2017, the COLA is 3%. Meanwhile, Part B premiums will be either $109 (current…
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Guidance on COLAs and Health Insurance Costs
DHCS has issued guidance about the effect of this year’s lack of a Social Security COLA on Medicare premiums and costs, along with other programs such as the Pickle program. The Medicare Part A premium increased to $411…
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New DHCS FPL charts for state health programs
DHCS has issued updated charts for monthly and annual FPLs. Effective dates vary based on program: FPLs are effective 1/1/16 for MAGI and non-Title II RSDI Medicare Savings programs, 3/1/16 for Title II RSDI MSP recipients, and 4/1/16…
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No increases in 2016 Spousal Impoverishment Caps
DHCS is not raising the community spouse resource allowance or the maximum spousal income allocation under the Medicare Catastrophic Coverage Act. These limits will remain at $119,200 and $2981, respectively. ACWDL 15-38 (12/18/15).