(California) Medi-cal / covered CA / Sharp mess

Until I get to speak to someone who can hopefully fix this mess, I would like to know the odds that it could indeed be fixed?

I was on Medi-Cal since the pandemic as I was pregnant and lost my job. During the pandemic and until the end of 2023, Medi-cal did not update people’s income as a gesture to help people get back on their feet (they told me that, and told me not to update my income until they ask me to). I did get a new job and my income varies, but annually my MAGI was about $58,000 (after 401k deduction) in 2023. I also had a second job that I quit in October and was only about $40 a month. I updated Medi-Cal about the end of job 2 and my estimated income for job 1. Sometimes a paycheck is gross $2700 sometimes it’s $1800. And again, they should only look at my income after my 401k deduction which is 10%. My last update was in December then nothing until Mid February when they informed me I no longer qualified for medical-cal but my children did. It appears she had calculated my income wrong but since I expected to be off medical and my kids still on it, I didn’t think anything of it. I went on covered California and updated my income there.

I was relieved to finally be able to pick a different health plan. I was a bit stressed on only having a few days to find a new PCP since I have medications that need refilled monthly, but I figured it out. I went on covered California, updated my income to estimated $61,000 a year (I picked “my income varies, and turns out my income will be lower actually), again removed job 2 that I had already removed 3 times, and uploaded my most recent paystub. I picked Sharp Silver 73 and my premium was $219 with no deductible. I paid for March on March 01 and then for April at the end of March, via autopay.

See also  Mental Health Office charging more than they initially quoted. What are my options?

Fast forward to last week, I got a letter from covered California stating my annual income was $72,500 and I was switched to Silver 70 with a premium of $380, starting April 1. The letter was dated March 29. I logged into my sharp account and was shocked to see a bill of $980, that includes $380 for the month of April (that I already paid with $219), $380 for May and $219 for May!!

I went onto covered California and updated my income this time to $59,000 with proof with my last paystub, and my premium went down to $179 starting May, but eligibility starting March 1.

I contacted Sharp and they said nothing to do with them please contact covered CA. They could see the new plan in their system.

I contacted covered CA and they said the county changed my income on 02/28 but no one contacted me about this. I went on my county account and it says nothing about an update.

So now… will they be able to retroactively change what I owe? My meds aren’t even covered by my plan… also, why is Sharp charging me twice for two different plans at the same time?

What happens about the bill since I can’t pay it?

submitted by /u/Mediocre-Cat31
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