Q: What is Covered California?
A: Covered California is a marketplace where individuals can compare and select private health insurance plans as well as determine if they are eligible for financial assistance to make coverage more affordable.
Q: Am I eligible for health insurance subsidies?
A: U.S. Citizens and persons lawfully present in California with incomes above 138% of the federal poverty level ($16,105 for an individual). – Tax Credits and discounts on monthly premiums are available to persons whose incomes are up to 400% of the federal poverty level, or $95,400 annually for a family of four.
Q: What is the penalty for not getting health insurance during open enrollment?
A: The Penalty for not having insurance in 2014 starts at $95 or 1% of annual income, whichever is greater, per adult and $47.50 for each uninsured child. In 2015, the penalty starts at $325 or 2% of annual income, whichever is greater, per adult and $162.50 for each uninsured child. In 2016, the penalty will start at $695 or 2.5% of annual income, whichever is greater, per adult and $347.50 for each uninsured child.
Example: Jim earns $45,000 a year and is uninsured. His penalty in 2014: $349, 2015: $721 and 2016: $930.
Eduardo and Julia have two children and earn $65,000 a year. They are all uninsured. Their penalty in 2014: $549, 2015: $1,133, and 2016: $1,460.
Q: What type of insurance will I get when I apply through Covered California?
A: There are 4 different plans to available to purchase on Covered California in Kern County. Anthem Blue Cross, Blue Shield of California, HealthNet, and Kaiser Permanente. This plans each have 4 different levels of coverage: Bronze (60%), Silver (70%), Gold (80%), Platinum (90%). Additionally, there are enhanced silver plans available for those with eligible income, with coverage at 73%, 87%, and 94%. If you qualify for Medi-Cal you will have options to choose between HealthNet and Kern Family Health Care.
Q: What options do undocumented Californians have?
A: Unfortunately, at this time, undocumented Californians are not eligible for insurance coverage through Covered California and Medi-Cal. However, there are still opportunities for undocumented individuals to get access to basic health care services and preventive care. – Community health centers (clinics) : Provide primary care, dental and other services, regardless of immigration status. If you are undocumented and need medical services, there are various Clinica Sierra Vista and OMNI Family Health sites in Kern County. – Emergency and pregnancy-related Medi-Cal: is available to undocumented Californians and, when needed, state-funded long-term care is also available.
Q: Why are individuals with temporary work or student visas eligible for Covered California, but not for Medi-Cal?
A: Under federal rules for the Exchanges, these individuals are legally present and may obtain coverage through Covered California. Under the state’s Medi-Cal rules, eligibility is unclear. Counties have assessed Medi-Cal eligibility for individuals with these types of visas differently , with some counties approving and others denying applications. If a Medi-Cal application is denied, individuals may seek coverage through Covered California even if they have incomes under 138% FPL.
Q: I am a DACA Student, are there options for me?
A: If you are income eligible and have Deferred Action you are currently eligible for free state funded coverage under Medi-Cal. Individuals eligible for DACA must: – Have come to the U.S. before 16th birthday. – Have continuously resided in the U.S.since January 1, 2010. – Have been physically present in the United States on Nov. 20, 2014 and at the time of making a request for consideration of Deferred Action with US Citizenship and Immigration Services. – Be currently in school, have graduated from high school, have obtained a GED, or have been honorably discharged from the Coast Guard or armed forces. – Have not been convicted of a felony offense, a significant misdemeanor, or three misdemeanors and do not pose a threat to national security or public safety.
Q: What is Medi-Cal?
A: Medi-Cal, California’s version of the federal Medicaid health program, provides free or low-cost medical, dental, mental health, substance abuse and long term services and support to eligible low-income citizens and immigrants.
Q: Can the state take my home away if I enroll in Medi-Cal?
A: No, state cannot take your home away. However, the state can make a claim against your estate for the amount of the Medi-Cal benefits paid or the value of the estate, whichever is less. The claim can only be made if: – You were 55 or older when you received Medi-Cal benefits. – You were permanently institutionalized at any age. – You were in long-term care services.
There are ways you can prepare for estate planning in order to deal with an estate recovery claim.
Q: I received a Form 1095-A in the mail from Covered California. What is it, and what should I do with it?
A: The 1095-A is similar to other tax documents that consumers commonly receive, like the W-2 and 1099 forms, and you will need to save it for filing your federal income tax return. This form helps to determine whether you received too much or too little financial assistance in paying for your insurance premium. Read more about this form here.
Q: I recently received a letter from Covered California. Where can I get more information?
A: Visit the Covered California Notices to Consumers page or call your Certified Enrollment Counselor for assistance.
Q: When will I get my bill?
A: Your health insurance company will send you a bill about two weeks after they receive your application or renewal. The payment due date will be printed on the bill. Please send your payment to your health insurance company before the deadline. If you pay your bill by mail, be sure you send it in time for the insurance company to receive your payment by the payment date printed on the bill. Your health insurance company also may accept payment through the phone or online, which would be faster than mailing your payment. Contact your health insurance company or visit the Paying Your Premium page for more information about payment options.
Q: Will I get a new health insurance card?
A: If you renew and keep the same health insurance plan, you can keep your current card for 2015. If you change coverage, such as metal tiers or health insurance companies, your health insurance company will send you a new welcome packet and health insurance card approximately 10 days after receiving payment.
Q: I applied for Medi-Cal but have not received any information from the county. What should I do?
A: If you have already applied, you do not need to apply again. Medi-Cal is processing your application as quickly as possible. Due to the large number of Medi-Cal applications received, processing is taking longer than expected, and proof of certain information is required in order to complete each application. If you need immediate assistance or have a specific question about your application, contact your Certified Enrollment Counselor for assistance with your application status.