Covered California is a new by the state, for the state agency that was put in place in order to supervise the buying and selling of health insurance and to help enroll eligible candidates for coverage.
Who does it benefit?
There are three main demographic groups who will benefit from the new healthcare exchanges: the poor, the low-income working class, and anyone who buys their own insurance. Essentially, anyone with an income below $15,400 per year will be qualified to take advantage of Medicaid – or Medi-Cal, as it is known in California. It is projected that this will help some 2.3 million uninsured Californians enroll in an individual California health insurance plan within the next 3 years.
What about immigrants?
Under this new plan, legal immigrants are eligible to purchase insurance plans through Covered California. They are also available for the government subsidies if they are qualified in terms of their income. However, illegal immigrants cannot buy insurance and are not eligible for Medicaid.
What will it offer?
Essential benefits are required under the new act, which include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitation services and equipment, laboratory services, chronic disease management services, preventative and wellness services, and pediatric services.
What are the bronze, silver, gold, and platinum color codes?
There are three different types of coverage policies available, and they are color-coded to match their offerings. The color codes reflect what percentage of health care costs will be covered by the insurance plan, as well as how much the monthly premiums and copays will cost for doctor visits and prescription drugs. Bronze is the lowest-cost plan, and on this plan the insurance company will cover 60% of expenses, leaving 40% to be billed to the patient. A Silver coverage plan will offer an average of 70% of expenses paid by the insurance company, and Gold will have an average of 80% paid by the insurance company. Platinum, on the other hand, offers the most coverage – up to 90% to be paid by the insurance company – but is also the most expensive on a month-to-month basis. According to Forbes, “Your share of costs might come in the form of a large deductible with low coinsurance once you’ve met your deductible. Another plan might offer a low deductible with higher coinsurance.”
As the result of these changes, it’s estimated that 2.6 million people will now be qualified to take advantage of financial assistance in paying for health insurance. Another 2.7 million will be newly eligible for guaranteed coverage. Emergency services will no longer be denied to those who can’t outright afford it in the state of California.]]>
What you should know is that your situation isn’t helpless. Affordable insurance is an option for nearly everyone in the state of California; it’s all a matter of shopping smart. If you’re in the market for health insurance – and no one should be going without doctor’s visits, prescription drugs, emergency care, and more – take these tips into consideration.
Seek Help First
Did you know that there are plenty of professionals from organizations such as the Patient Advocate Foundation that can assess your unique situation and provide you with advice that’s personalized for you? It’s never a bad idea to have someone with experience and knowledge to provide you with information about your options to ensure you end up with a policy that’s sufficient in terms of both coverage and affordability.
Begin the Search
After you’ve got the proper guidance, begin searching for health insurance. You could potentially go through your employer, but sometimes it’s more affordable to get your own policy. To see if this is the case in your situation, make use of a website that offers California health insurance quotes so you can do a coverage and cost comparison on policies from a number of different providers.
Consider your Kids
A lot of families think that since they don’t quite qualify for Medicaid, they won’t be able to afford getting health insurance for their children. This isn’t the case. Even in the event that you do make too much money to qualify, your kids might qualify for the State Children’s Health Insurance Program or one of the many other government programs. Read about what it takes to qualify for SCHIP in the State of California.
Consider your Needs
If you’re affected by a specific disease, you probably spend more on average on healthcare costs than many other California residents. However, this also means that you could qualify for financial assistance. There are many charities and foundations that offer assistance to sufferers of specific diseases, such as Heart Support of America and Empowered Patient. Don’t hesitate to take advantage of one of these foundations if you find that your health insurance policy simply isn’t getting the job done.]]>
The current issue, however, lies in the fact that more than half of the population doesn’t know that they can now afford coverage.
A recent poll, called the Field Poll, surveyed uninsured, low-income voters who would technically be qualified candidates for health coverage. The poll found that more than 50% of these people either a) did not know that they qualified for health insurance, or b) believed that they did not qualify for health insurance. When participants who were qualified, but not under an employer, were surveyed, the percentage who did not know about their qualification was even larger.
Clearly, the state of California has an issue of awareness on its hands.
What can be Done / What is Being Done
It’s now up to the state agency who is behind the Obamacare overhaul to inform and educate the public about the fact that they may be newly qualified or able to get more affordable care. As of right now, advertising seems like one of the only options. Statewide, we may be looking at an investment of over $300 million that will go toward the endeavor of spreading the word about new health care. This will be in various forms – from door-to-door visits to online advertisements, all geared toward the uninsured and convincing them to take what’s theirs.
The issue, however, isn’t simply about awareness – it’s about understanding. Some 25% of the population knows nothing about the new Affordable Care Act. Another 60% consider themselves to be “somewhat knowledgeable.”
Since lack of healthcare is a huge issue in the United States, it’s important for California residents to be aware that they might qualify for policies with Health Net California or one of the many other reputable insurance agencies. Many citizens tend to tune out when they hear mention of “health care reform,” but since this plan is put in action to literally revolutionize the way that lower-income residents buy and use their health insurance – while making the stipulations more transparent and the competition and pricing more fierce – it’s an act that pertains to everyone. Do your research!]]>
Perhaps the biggest change is the introduction of Covered California, the new health insurance marketplace designed to ensure that buyers are getting health insurance policies that meet federal standards for quality and create a competitive landscape for insurance providers. If desired, consumers can still purchase their policies through brokers and directly through licensed carriers; however, the government will be providing subsidies to qualifying patrons through the marketplace.
For customers who wish to use the Covered California marketplace, the open enrollment will begin on October 1, 2013 and end on March 31, 2014. This is the time period during which the buyers can obtain their California family health insurance for the 2014 year.
No matter how you choose to purchase your health insurance, you’ve likely seen and will continue to see the changes in healthcare benefits that have been implemented. For one, the age cutoff for coverage for dependents is now 26 years old, regardless of their current residency, education, employment, or marital status. Furthermore, no enrollees with pre-existing conditions can be denied if they are under the age of 19. While formerly there was a limit on the amount of dollars spent in a lifetime – and sometimes, annually – in healthcare on a specific enrollee, that provision has been lifted. Women’s preventative health services will now be free of charge under the new act as well. Finally, patients have more rights to choose their primary care provider; there is no longer a necessity for a referral for an OB/GYN, no increased copay for out-of-network emergency care, and no need for authorization for emergency visits.
In tandem with the changes to provisions will be the enforcement of new rules. For one, health insurance providers must continue to provide care during time when an appeal is still pending. Under the New Rescission rules, a person cannot have their healthcare rescinded once enrolled under an Individual and Family plan unless they have intentionally misrepresented their facts. Those enrolled in small group health plans will also notice that the Medical Loss Ratio, or MLR, has changed – no more than 80% (85% for large groups) of revenue can be spent on medical costs; if this number is exceeded, the covered person will be entitled to a rebate.
Finally, and perhaps most importantly, all covered persons will receive standard documentation that thoroughly outlines their policies to avoid confusion and insufficient coverage for costs.
Though the healthcare changes got mixed reviews from the public, the changes are put in place and should benefit the customer overall.]]>
So what exactly are a young adult’s options for health insurance? Not every workplace offers it to new employees, but that doesn’t leave you high and dry. You do have options, in part due to the implementation of the Affordable Care Act.
Did You Know: The Age of Dependency has been Extended
Many young adults aren’t aware that they can still be insured as a dependent on their parents’ healthcare plans after they turn eighteen. Due to the Affordable Care Act, you can still be listed as a dependent until you’re 26 years old if you don’t get job-based coverage. This buys you a little extra time to get settled into a career and get job-based coverage or find an independent plan.
For Young Adults with Limited Income
If you don’t have health insurance because you can’t afford it, 2014 may be your year. Starting next year, unemployed adults with limited income may be eligible for free health insurance through Medicaid.
Buying Insurance Independently
It may become your only option if your parents don’t have health insurance and you’re self-employed, unemployed, or new to the workforce. Buying health insurance, if you can afford it, is sometimes a necessity – though it might be a bit expensive, an uninsured trip to the hospital is even more expensive. It’s all about shopping smart. Remember that a lower premium, though it may appear to be more desirable, usually offers less comprehensive coverage or a very steep copay. Try using sites that offer health insurance quotes, like this one for Anthem Blue Cross of California, while also having thorough information about the coverage, and choose the best option.
What Else you should Know…
Remember that if you buy a short-term plan just to last you until you get a better one, it will likely be expensive and have limited coverage, so only do so if necessary. If you’re newly married, don’t forget about maternity coverage – this is something newlyweds often forget! And finally, there are many new changes coming in 2014 that will benefit the unemployed and low-income workers.]]>
In 2014, no one can be denied health insurance, regardless of your pre-existing condition. So this is a really good thing. However, no one really knows the true impact that will have to prices. Keeping the cost constant for a bit, then it will come down to coverage and carrier. When shopping for individual health insurance in the near future, it will be important to understand everything you are getting when making a decision. Research if your doctors are covered with the carrier. Know what is the difference between out-of-pocket maximums and deductibles. Figure out which coinsurance limit will be best suited for you and your health history. We will find out real soon how the health insurance industry will evolve because of the health care reform.]]>
In addition to the price increase, the plans will be redesigned as well. There will be different levels of coverage options. The goal is to simplify the options for consumers and also to make the benefits more rich in nature. For people that are looking to get a subsidy from the government, that will also have its requirements. First, you will have to apply for health insurance through the state exchanges that are scheduled to be operational by 2014. Also, there is an income hurdle to qualify. To get a subsidy, you can not make more than 400% of the poverty income level. So that means that many of the 8 million Californians without coverage right now might not even qualify for a discount. As we get closer to 2014, we will release more information about the changes coming about.]]>
Many people who make $10 dollars an hour, trying to make a living, do not have and can’t afford to get health insurance. America needs quality leaders to oversee the health care system and the implementation of it coming next year. Most are predicting that the healthy will pay for the poor, just like the rich pay for the poor when it comes to government programs, etc. Next year everything takes affect, we will find out soon.]]>
From a care standpoint, this is obviously a great thing because everyone should have access to care. However, from a pocket book standpoint, everyone will pay the price. The main reason for this is because the healthy will have to pay for the sick. There are 8 million uninsured in California alone that might be entering the market starting in 2014 when its required to have health insurance. The sick pool will need the most money to pay for their claims, and that will only come from the healthy.
The health care laws also state that the premiums can not vary too much based on age and that it will be a community rating. This will probably benefit the older more than it will the younger. Since the older population have higher health costs, the younger segment will pay for this difference. So what do we do at this point? Well, there actually is no easy answer to that. We have to all hope that the reform rules and regulations will not effect the market as much as all these top insurance carriers do.]]>