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Signing Up for Medi-Cal or Covered California: Everything You Need to Know Before Enrolling
Slobodyany Insurance Agency
Source: Desert Sun
Starting in January, Californians will be required to sign up for health insurance or face a $695 tax penalty under the new state mandate.
Covered California open enrollment for 2020 runs from Tuesday Oct. 15 through Jan. 15. If the enrollment period is missed, people won’t be able to sign up for coverage unless they qualify for a special enrollment period because of a major life event, such as having a baby, getting married or losing other coverage.
Researchers estimate that 730,000 people who are eligible for Medi-Cal in 2020 will not enroll, according to a report from University of California, Berkeley, and UCLA. In 2016-17, about 543,000 Californians were eligible but not enrolled.
The number of uninsured people is expected to increase because the federal individual mandate was repealed. California’s new state mandate is one method policymakers are using to push people to sign up for insurance.
California also will offer new subsidies in 2020 aimed at making health coverage more affordable for middle-income individuals and families. The subsidies are for individual Californians who earn between $50,000 and $75,000 and families of four earning $103,000 to $155,000.
Also new in the coming year, low-income undocumented young adults ages 19 to 25 will be able to sign up for Medi-Cal.
Despite these moves to make subsidized coverage accessible to a larger swath of people, experts predict that many still will not enroll because of lack of knowledge about the programs, confusion about how to sign up, or unfounded fears that signing up could expose family members who are undocumented to deportation.
his guide is meant to explain what coverage options you might qualify for and how to do so. If you qualify for coverage, signing up will not put undocumented family members in danger of deportation or punishment because health providers are not allowed to give personal information to immigration authorities.
Any U.S. citizen or green card holder living in California who does not have insurance offered by their employer can enroll in a health care plan regardless of income through Covered California, the state’s health insurance marketplace. Income determines whether you are eligible for free or reduced-cost health insurance or if you qualify for a subsidy (subsidized coverage may depend on whether a person has access to insurance through an employer). If you don’t qualify for financial assistance, you can still purchase private health insurance through Covered California.
What do I qualify for?
Medi-Cal: The free or low-cost state health insurance program. It’s California’s version of the federal Medicaid program.
Medi-Cal for low-income pregnant women: This program provides immediate no-cost pregnancy-related care to low-income women while their application is evaluated for ongoing post-pregnancy Medi-Cal coverage.
Medi-Cal Access Program for Infants and Mothers (AIM): AIM is a low-cost health insurance program for pregnant women who don’t have health insurance and whose income is too high for no-cost Medi-Cal. It’s aimed at providing health insurance to middle-income pregnant women.
Medi-Cal for children: This program provides coverage for children under 21, based on their parents’ income.
C-CHIP, the County Children’s Health Initiative Program: This program is provided through all counties in California. It provides coverage for children up to age 19 who don’t meet the income requirements for Medi-Cal for children.
Medi-Cal for legally undocumented young adults ages 19 to 25: This coverage option starts Jan. 1, 2020, and is for any undocumented young adult, including those who fall under Deferred Action for Childhood Arrivals (DACA).
American Indian/Alaska Native zero cost share: If an American Indian or
Alaska Native chooses to purchase coverage through Covered California, many will not have to pay out-of-pocket costs such as copays and deductibles. If people choose not to enroll in coverage through Covered California, they will be exempt from the individual mandate tax penalty if they receive care from an Indian Health Services provider.
Covered California’s four private health insurance plan groups:
Platinum plans have the highest premium, or monthly fee, but they cover about 90% of your health care expenses. Gold plans pay about 80%, silver plans pay about 70% and bronze plans, with the lowest premium, cover about 60% of health costs.
Qualifications: Any U.S. citizen in California, a lawfully present immigrant or a green card holder. Income guidelines are the same for everyone who qualifies. (DACA recipients do not qualify to purchase insurance through Covered California, but they may qualify for Medi-Cal.)
Covered California has several subsidized enhanced silver plans that have income requirements. They are:
Covered California, Silver Enhanced 94 Plan: This plan covers 94% of the average annual cost. A primary care or urgent care visit carries a $5 copay.
Covered California, Silver Enhanced 87 Plan: This plan covers 87% of the average annual cost. A primary care or urgent care visit would cost $15.
Covered California, Silver Enhanced 73 Plan: This plan covers 73% of the average annual cost. A primary care or urgent care visit would cost $35.
Covered California State Subsidies: California offers new subsidies in 2020 aimed at making health coverage more affordable for middle-income individuals and families.
Medicare: This is the federal health care program for seniors.
How can I apply?
Find a location nearest you by calling (800) 300-1506 or going to this website. Riverside County Medi-Cal offices are at:
Private health insurance brokers can help people navigate Covered California while health navigators at local nonprofits and federally qualified health centers are able to help patients sign up for Medi-Cal.
In Riverside County, people can find assistance at Borrego Health, The Desert AIDS Project, the Coachella Valley Rescue Mission, Martha’s Village and Kitchen, the Inland Empire Health Plan and Molina Healthcare, among others.
What documents and information do I need?
To your success, Slobodyany Insurance Agency Celebrating 12 years of serving community strong
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5301 Madison Ave., Suite # 204, Sacramento, CA, 95841
Tel: 916 970 3707
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