What Is Covered California?
When the Affordable Care Act was signed by President Barack Obama in 2010, each state had to choose between creating their own state-based marketplace or use HealthCare.gov. The state of California elected to develop their own, and Covered California was created shortly after. It’s been operational for the last five years and serves the entire population, which equates to approximately 39 millions residents.
Therefore, residents of California cannot use HealthCare.gov. Instead, they must go to CoveredCA.com during the Open Enrollment Period (OEP) to shop for and purchase a health insurance plan.
When Is The Open Enrollment Period?
The 2018 Open Enrollment Period for residents of California begins on November 1, 2017, and ends on January 31, 2018. This provides the public exactly 91 days to adequately shop around and purchase a health insurance plan.
Meanwhile, the Open Enrollment Period for the rest of country only lasts 45 days because the majority of the states use the federally facilitated marketplace. These states do not control the marketplace and therefore cannot extend their OEP period like the state of California.
How To Make Changes To Your Coverage
If you’re thinking about making changes to your health insurance plan, you can always rely on AffordableCalifornia.com to provide the latest information and help you compare different plans during the enrollment period. There’s seemingly an infinite amount of information floating around these days, and it can be difficult to choose a plan that suits your specific needs and budget.
If your household income has changed or the size of the household has changed within the last year, it’s important to make changes to your plan. Many Americans don’t realize they may be able to qualify for Obamacare tax credits, which could partially subsidize the cost of your monthly premium. Our agents will be able to assess the situation and provide a thorough analysis that will yield positive results.
Affordable Care Act Alternatives
Those who choose not to purchase a plan during the Open Enrollment Period will be subjected to an array of fines when it comes time to file your taxes. However, there are several health care alternatives that are exempt from these Obamacare penalties, such as Health Share Advisors.
This is a health sharing ministry, which comprises a large group of individuals bound by a common faith that shares the costs of health care amongst each other. This alternative option is usually more affordable compared to Obamacare premiums and has gained popularity over the last few years. Under the Affordable Care Act, if an individual or household is a part of a health sharing ministry, then they’re completely exempt from the hefty fines that apply to uninsured individuals.
Do You Have Questions?
Are you currently living in California and are thinking about shopping around for a health insurance plan? Do you have questions or concerns regarding this subject? Give us a call at 800-788-2197 and speak to one of our agents today! They’ll be able to explain everything in detail and address all of your queries.Read More >>
Californians can expect a few changes this year when they’re purchasing a 2018 plan. Luckily, we’re here to break down all the information and provide the latest details so you can make an informed decision.
The Open Enrollment Period
This year, the 2018 Open Enrollment Period (OEP) for residents of California will begin on November 1, 2017, and end on January 31, 2018. So, state residents have precisely 92 days to shop around for a plan through the state-based exchange. California’s OEP differs from the rest of the country, as the majority of states use the federally facilitated marketplace.
A New 25% Surcharge
For the past few months, there have been several rumors in the media indicating that California will introduce new measures to counter the possibility that Congress won’t fully commit to cost-sharing reduction payments. Now, that may sound like a mouthful, but remain calm and let’s dissect the details.
Cost-sharing reduction payments (also abbreviated as CSRs) play a pivotal role in keeping Obamacare plans affordable. It’s primarily federal money siphoned from Capitol Hill to various insurance companies across the country that fall under the umbrella of the Affordable Care Act. This money partially pays for the cost of premiums, which results in savings for millions of Americans each year. Although, in recent months, President Donald Trump has made repeated threats to cut off these crucial CSR payments, creating an environment of uncertainty in the insurance sector.
Covered California has reacted by establishing a 25 percent CSR surcharge on both their gold and silver plans. Now, this may seem reactionary, but this increase safeguards several insurance companies if the federal government suddenly pulls the cord on these CSR payments in the upcoming year.
Certain Providers Pulling Out
According to newly released information, Anthem Blue Cross will be pulling out of 16 regions across the state. This will affect roughly 300,000 individuals, which include those who were planning to purchase coverage outside of the Open Enrollment Period. There is some good news though, as Anthem has stated it will continue to operate within the following regions; The Northern Counties, Santa Clara County, and the Central Valley. Meanwhile, Health Net will be leaving northern and central California, where Anthem primarily operates.
On the flip side, some carriers are increasing their coverage. According to recent data, Oscar is expected to expand to Northeast Los Angeles, while Blue Shield will reach Contra Costa, Alameda, Ventura, Marin, and San Luis Obispo.
Do You Have Questions?
We understand this subject is incredibly dense and complicated, so if you have any remaining questions, feel free to call one of our agents here at Affordable California. We can explain all of the information above in great detail and answer all of your pending queries. Phone us today at (800) 788-2197.Read More >>
Marketplace health insurance coverage can be renewed for 2016 now. Open Enrollment for 2016 Health Marketplace Insurance plans begins in November but you can renew your policy now and it’s easy to do.
Important dates for 2016 enrollment:
November 1, 2015: Open Enrollment starts — first day you can enroll in a 2016 Marketplace plan
January 1, 2016: First date 2016 coverage can start
January 31, 2016: 2016 Open Enrollment ends
7 things to know about renewal and auto-enrollment:
1) All Marketplace health plans will come up for renewal soon. Open Enrollment for 2016 health coverage through the Marketplace begins November 1, 2015.
2) Your insurance company will send you information this Fall about updated premiums and benefits.
3) Review your plan’s 2016 changes to see if it still meets your needs. Our expert agents can also help you find the best plan options.
4)If you’re happy with your current plan and want to keep it–and your income or household size haven’t changed – you don’t need to do anything. The Marketplace will auto-enroll you in the same plan for 2016.
5)If your income or household size have changed, you’ll need to report that to the Marketplace so you get a tax credit if you qualify.
6)If you want to change plans, you can:
a) Choose any other Marketplace health plan your company offers in your service area if you want to stay with your current insurance company.
b) Choose a new health plan from a different insurance company through the Marketplace.
c) Buy a new private health plan outside of the Marketplace. If you do this, you won’t be eligible for premium tax credits and cost-sharing reductions offered through the Marketplace.
7)In some cases, your current Marketplace plan won’t be offered in 2016. If that’s the case, we’ll automatically enroll you in a similar plan so you don’t have a gap in health coverage, unless you choose another plan and enroll. Because your plan is ending, you’ll qualify for a Special Enrollment Period that lets you enroll in an individual plan outside the Open Enrollment period.
Our certified Covered California agents can help you with the renewal process now. Give us a call and review your best options and beat the open enrollment period crowds. Health Insurance Renew for 2016 Now!
A Special Enrollment Period, also known as an SEP is a 60 period of time that a person or family can use to enroll in healthcare or change their existing healthcare plan through the Health Marketplace. Open enrollment for healthcare occurs between the months of November-February but there are several qualifying life events that allow for a special enrollment period of 60 days from the time of the event. The following are a list of the most common life events that allow for a special enrollment period:
-Marriage Getting married or entering into a domestic partnership
-Death of spouse
-Birth of a child
-Adopting or fostering a child
-Child aging off of a plan – when a child turns 26, they are no longer eligible for their parents health insurance plan
-Returning from active military service
-Moving to a different town
-Employers Healthcare plan downsized – insufficient level of coverage
-Change in citizenship status
– Change in subsidy eligibility
– Experienced natural disaster
If you think you have experienced a life event that would qualify you for a special enrollment period for healthcare, please give one of our expert certified special enrollment agents a call to help you determine your eligibility for enrollment and subsidy assistance.
Open Enrollment for the Health Marketplace begins November 1st, 2015 for 2016 coverage. Here are some things to know and tips to make California Health Marketplace work for you. Most Americans must purchase insurance, get an exemption or pay a per monthly fee for every month they go without coverage. If you don’t like your current plan or don’t have insurance, you can apply for a marketplace plan to see your options. Applying doesn’t mean you have to enroll. The Open Enrollment period allows you to enroll for insurance offered in the Health Marketplace and apply for financial assistance and applications are being taken now for coverage to begin in 2016. If you have a life-changing event such as the loss of a job, death of a spouse or birth of a child, you may be eligible for special enrollment within 60 days of the event outside of Open Enrollment.
When you are getting ready to apply or renew your policy, Have the following family information available:
1. Last years tax information for you and your family
2. Projected incomes for this year
3. Medical history – Pre-existing conditions and gender will no longer affect the cost of your insurance.
4. Social Security Numbers (or document numbers for legal immigrants)
Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms—Wage and Tax Statements)
5. Policy numbers for any current health insurance plans covering members of your household.
6. Any other important information that could affect your health insurance premium or coverage options.
Choosing an Insurance Plan
After filling out your information you will be able to start shopping for health insurance. You will be able to compare plans, premium rates and benefits.
Regardless of what tier of plan you purchase all plans must cover:
1. Ambulatory patient services
2. Emergency services
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and rehabilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
Types of Health Insurance Plans
There are a number of different tiers of plans available on your health insurance exchange.
1. Bronze plans split covered expenses 60-40 on average. A Bronze plan is a good choice for those who don’t plan on using many medical services. Many low-income Americans may qualify for free or very low-cost Bronze plans.
2. Silver plans split covered expenses 70-30 on average.
3. Gold plans split covered expenses 80-20 on average.
4. Platinum plans split covered expenses 90-10 on average. Platinum plans have the lowest out-of-pocket costs and the highest monthly premiums.
5. Catastrophic Coverage is available to some people under 30 and those with hardship exemptions. Catastrophic plans only cover the bare minimum health benefits and have a limited network. You’ll have high out-of-pocket costs and a high deductible.
Subsidies or financial assistance are given in the form of tax credits based on your income and are paid by the health insurance companies toward your premium on a monthly basis. Keep in mind that you may lose or gain cost assistance as your income fluctuates throughout the year. If your income increases the difference will be reflected on your tax returns.
Facts about Premium Health Insurance Tax Credits/Subsidies:
Tax credits can:
1. Lower the cost of your premium.
2. Reduce the amount of the premium you will pay for insurance.
3. Help low-income and middle-income individuals and families
4. Are available to individuals and families who meet certain income requirements.
5. Can be applied to the cost of your health plan when you enroll – you do not need to wait until you file a tax return at the end of the year.
6. Are paid directly to your health plan. These tax credits are paid by the Health Insurance Marketplace to your health plan to keep your out-of-pocket costs low.
7. Will be adjusted at the end of the year based on your actual income. At the end of the year, the tax credits may be adjusted if your income is different than you anticipated. This means you will want to notify your insurance agency if your income changes.
Hopefully, these tips to make California Health Marketplace work for you have helped! Our certified Covered California insurance agents can help you calculate the cost of insurance for you and find the best plans at the best price. Give us a call today and see what great health insurance options are available.
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If you are shopping for health insurance, look no further, you have found a Certified Covered California Service Center and we are excited to help you find the perfect health insurance plan. Our certified Covered California agents are knowledgeable and understand the world of health insurance. They are experts and can help you feel confident about the choices you make when purchasing such an important investment in your health.
Our Agents Are:
1. Up to Date with the latest health insurance information.
2. Flexible – Customizes your plan based on your insurance needs.
3. Detail Oriented- Make sure every detail is taken into account and every step of enrollment implemented.
4. Organized- able to navigate the world of health insurance and streamline your options for you. Finding possible subsidies available to lower cost of insurance.
5.Friendly and Personable. Our agents go above and beyond the basic service. We try to build relationships with our customers so that they want to continue to work with us and also they they would recommend us to a friend.
6. Calm Under Pressure- They meet deadlines and make the shopping experience fun.
7. Excellent Communicators- they are able to listen to customers and hear what their insurance needs are. then find the best strategies to meet their needs.
8.Fast- They can expedite enrollment.
There are many options when choosing a health plan, our agents will help you pinpoint the best plans that fit your needs and expedite your enrollment. We can also help you with future questions if you are thinking of changing your plan, or need to update it because of a Life Changing Event such as getting married, having a baby or losing your job/healthcare. Enrollment for healthcare can be enjoyable and the ongoing maintenance of your insurance plan can be with Affordable California as your certified Covered California Service Center!
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It’s never too early to start planning for retirement, in fact, healthcare planning is an integral part of a retirement plan. A good healthcare plan helps a person enjoy their retirement by keeping their mind and body healthy. The question of when is Covered California better than Medicare is important to take into consideration when shopping for plans. There are certain situations when a person might find Covered California to be a better choice for their healthcare in retirement. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
One reason that a Covered California plan might be the best option is if the individual does not qualify for Medicare. There are several reasons a person might not qualify for Medicare one being if the person is under the age of 65 and has no disabilities. Another reason is if the person or their spouse did not pay into Social Security in their working years. If the individual or couple is below a certain income, Covered CA might be a better choice. If a person needs temporary insurance while waiting for approval for Medicare because of disabilities, a Covered CA plan might be a good option.
Usually if someone is eligible for Medicare (even if they do not enroll in it ) they cannot receive tax credits to help them pay for a Covered California health plan. If a person chooses to enroll in a Covered California health plan instead of Medicare and then enroll in Medicare later, they may have to pay a late enrollment penalty. Medicare Part A has a premium: However, if someone qualifies for Medicare but has to pay a premium for Part A and does not enroll in Medicare Part A, they may be eligible for a Covered California health plan. Depending on a consumer’s income, they may be eligible for premium assistance and cost-sharing subsidies for the Covered California health plan.
An individual who has a permanent disability, but is not yet eligible for Medicare due to the two-year waiting period for people receiving SSDI payments, may purchase health coverage through Covered California. Depending on income and if otherwise eligible, the individual may get help paying for a health plan through Covered California or get low- or no-cost Medi-Cal.
There are certain situations when a person might find Covered California to be a better choice for their healthcare in retirement. Our agents can help analyze your particular situation and help you find what your best options will be.
Give us a call at 1-844-366-5126
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Will there eventually be an employer group health plan extinction when the family subsidy is unlocked? Possibly! Group health insurance plans are not always the best option for employers or employees for several reasons. One reason being that it is becoming more common for companies to only pay for their employees coverage, making it expensive to get the whole family covered. Another reason is that group health insurance plans can take a lot of time and money for employers to set up and manage for their employees. The employee also has less control over selecting, customizing, and managing their plans since they are group plans. Employees can also miss out on receiving subsidies (financial assistance) that is offered through health marketplace plans (if they qualify) because they are not offered through private group plans.
If your household income is below a certain amount, it might be considerably cheaper to purchase an individual plan through the health marketplace rather than a group plan through your employer because of subsidies. Sometimes companies might even give an allowance to their employees to help them purchase their own plans giving them the ability to afford high quality insurance that they select and manage themselves. Open Enrollment begins in November for a Health Marketplace plan, but you can start shopping now to learn what your best options will be and start deciding what type of plan you would like to eventually have. If you have a qualifying life event such as losing your job, a change of marital status, having a baby or child age off of a plan or are moving to a new town you may enroll for insurance through the health marketplace right now! You have 60 days from the time of the life event to enroll and our agents can help you determine if you qualify for subsidies.
Whether you buy a platinum, gold, silver or bronze plan, a health marketplace plan or a private plan there are always insurance options for every situation. All plans have certain basic services and options available so that quality healthcare can be affordable to all. Many insurance options are available and oftentimes with subsidies/discounts! If you would like to learn about more affordable alternatives to group health insurance our certified agents can help you shop and compare your best plan options.
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With the many benefits that come with the new health marketplace insurance, comes also the need to effectively manage your health marketplace plan options. These top 3 tips to manage your health marketplace choices can help:
1. Know the benefits of a health marketplace plan. Here are some unique characteristics about marketplace plans. Marketplace medical insurance includes essential health benefits (aka – what major medical health plans are now required to cover by law), which are:
- Ambulatory patient services—outpatient care without being admitted to a hospital
- Emergency Services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral treatment, counseling and psychotherapy
- Prescription drugs
- Rehabilitative and habilitative services and devices—services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services—including dental and vision care
2. Select your doctor/hospital. Call to confirm providers with your insurance company and understand if they are in network or out of network. Most health plans give you the best deal on services when you see an “in-network” doctor who has a contract with your health plan.
3. Use your insurance services
- Make sure your covered – If you think you’ve signed up for health insurance but haven’t heard from your insurance company, call to make sure they have received your payment and that you are covered. Pay your monthly premium to avoid coverage gaps. Call your insurance company if you haven’t received your cards to send new ones.
- Use Preventative Services/Wellness Services. Annual check ups, screenings and other wellness services will help you get and stay healthy.
- Get Emergency Care – In an emergency, you should get care from the closest hospital that can help you.
- Knowing the Details of Your Plan– Now that you have health coverage, learn what you can do to stay healthy and get the care you need.Knowing your plans specific benefits, services, and options can help you be prepared for using the services.
Knowing the top 3 tips to manage your health marketplace will help you make the most of your insurance plan and support you in creating and maintaining a healthy life. Call to receive certified agent support:
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It’s officially summer and so it’s the perfect time to enjoy the great outdoors at the beach or swimming pool. It’s also outside of the Open Enrollment Period. The next enrollment period for health insurance in the health marketplace will begin November 1st, 2015, but that is about 5 months from now! What is available before Covered California Open Enrollment 2015? There are health plans for every life situation! Whether you need a short or long term plan, there are all kinds of plans to meet your needs.
Some of the Individual and Family Health Insurance Companies in California:
- Anthem Blue Cross
- Blue Shield of California
- Chinese Community Health Plan
- Health Net
- Kaiser Permanente of CA
- Moda Health Plan of CA
- Sharp Health
- Western Health Advantage
- HCC Life Insurance Providers in California
- IHC Group
If you have a Life Event such as getting married, having a baby or losing your work place insurance, you can apply for health insurance through the marketplace within 60 days of the event. . If you don’t have a qualifying Life Event, and need insurance before Open Enrollment in November, a private plan is a good option. You could get a short term plan and wait for open enrollment and possibly be eligible for subsidies at that time. Short and long term plans are available
Some of the advantages of buying a short term plan:
- Low Cost
- Quick Approval
- Up to 364 days of coverage
- Drop monthly charges at anytime
- Freedom to chose own doctor and hospital
- Can fill in the time before Open Enrollment in November for the Health marketplace plans- (can be a temporary plan).
- Fills in insurance gaps, between jobs, school, etc…
If you are a small business owner and would like to find out alternatives to Group health plans,we can help you find more affordable options. What’s available before Covered California Open Enrollment 2015? Call one of our knowledgeable insurance agents because they can help you determine what type of plan(s) would work best for your situation and customize your enrollment.
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