by Guest » Fri Aug 30, 2013 08:12 pm
I am 7 month pregnant and have medical. Now I started working about 3 months. I will have my benefits kick in in about 1 more month. What should I do in regards to what will benefit me more? Will my benefits effect me for having Medical?
Posted: Tue Sep 03, 2013 02:18 pm Post Subject:
Do you mean Medi-Cal -- California's version of Medicaid?
Posted: Wed Sep 04, 2013 06:23 am Post Subject:
Yes!
Posted: Wed Sep 04, 2013 01:45 pm Post Subject:
Eligibility for Medi-Cal is based on monthly reporting of income. What will happen to your income when you go on maternity leave? How long will you be off work, and do you plan to return to work?
The timing of all this is strange. You will have access to employer-sponsored coverage about the same time you will depart on maternity leave. Your employer will be forced to continue your benefit while you are on leave, but you will have no income, I assume.
Apparently your income is low enough to qualify for Medi-Cal, but any employer-sponsored health plan will be primary to Medi-Cal.
You will need to discuss all of this with your Eligibility Worker so that you do not create any problems for yourself by using Medi-Cal when you should be using your employer-sponsored plan. When your baby is born, it will have coverage, but you must enroll the child in your employer-sponsored plan and begin paying any additional premium within 30 days of birth to maintain the child's coverage.
Compounding all of this is the implementation of the Affordable Care Act. If the "self-only" cost of your employer-sponsored health plan in 2014 is more than 9.5% of your 2014 household income (Modified AGI), you may qualify for tax credits which would lower the cost of health insurance purchased through the Covered California exchange.
But if your household income is less than 138% of the Federal Poverty Level (example: about $15,856 for a household of one, and $32,499 for a household of four), then you remain eligible for Medi-Cal, and cannot purchase a health plan or receive tax credits through the exchange, but can remain enrolled in your employer's plan, assuming you continue to work.
Very confusing, isn't it? Your best bet will be to meet with a CA licensed agent after your baby is born and during the "Obamacare" Open Enrollment Period beginning on October 1 (it ends on March 31, 2014, but you don't want to wait that long) -- you should make your decision before December 15 to assure coverage will be in effect, one way or another, on January 1, 2014. You can email me for more information -- click on the link below.
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