While his wife was busy caring for their disabled mother-in-law, John lost his job due to COVID-19 and struggled to obtain unemployment benefits. This caused a drastic decrease in their income, but his premiums for healthcare were increasing from $41 to $375 in June of 2020, which was a plan with less benefits and higher costs. Since he reported his COVID-19 related unemployment income to the San Bernardino County Medi-Cal office, the premiums were going to jump AGAIN in July to $1560. John did not know what to do next.
As the premiums became drastically unaffordable, he decided to terminate his coverage. Being unemployed and having significantly reduced income now, John applied for Medi-Cal, but the County verbally denied him due to verification and having high income in one month. The County mandated he prove he no longer had unemployment benefits, but how could John prove something that did not exist? John then approached ICLS in August, uninsured and with an urgent need for diabetes medication that they would run out of in three weeks.
ICLS identified that the household would have $0 countable income due to the special Medi-Cal income rules, which allows the wife’s caregiver employment income to not count towards their eligibility. This means the client would be eligible for full-scope MAGI Medi-Cal at zero cost.
In August 2020, ICLS submitted a special request to Covered CA on John’s behalf to help him obtain the Medi-cal. Within 2 weeks, ICLS and Covered CA helped coordinate with the County to approve Medi-Cal for John in August and September 2020. This meant he and his wife could now access their diabetes medication at $0!
*John is an alias to protect the identity of our client