Getting the care you need to grow healthy starts with having the information to make the best decisions about health care for you and your family.
You can get a better understanding of your choices with this FAQ. We also offer resources for more information and can walk you through your options for free.
Q: What Is Open Enrollment?
A: Open enrollment is the period each year when everyone has the chance to choose their health care and insurance coverage for the next calendar year. People can decide to stay with their current plan or switch to one that does a better job at meeting their budget or health care needs.
Things to consider:
⦁ The monthly cost or premiums
⦁ Which doctors and hospitals you can visit
⦁ How much you pay for each office visit, prescriptions, and other services
⦁ How much you have to pay out-of-pocket for the year
⦁ If certain care like dental, vision, or counseling is covered
For those on Medicare, open enrollment is also the time when you can choose which doctors and health systems you want to go to. If you’d like to make sure you can see AltaMed doctors, call us so we can help you make the switch.
Q: When Is Open Enrollment?
A: That depends on your insurance or medical coverage. The open enrollment period for Medicare runs through December 7. Open enrollment for Covered California is November 1 through January 31.
Q: Am I Eligible for Medicare?
A: Medicare is usually reserved for people who are 65 years old or older. You can sign up three months before you turn 65 during the open enrollment period. Younger people with kidney failure requiring dialysis or transplant are also eligible.
There are two parts to Medicare. Part A is hospital insurance and Part B is medical insurance. Part A is free if you’re 65 and you or your spouse paid Medicare taxes for at least 10 years. Part B requires a monthly premium which is deducted from your Social Security check. The premium varies based on income. In 2020 it ranged from $144.60 to $491.60. It covers doctors’ services, outpatient care, home health services, durable medical services, and other medical services.
Q: Should I Just Take the Insurance Offered by My Employer?
A: That seems like a good and simple idea. But it might not be the best for you and your family. Even if employers pay for part of your plan, it may not offer the right kind of coverage and could be expensive.
Research all your options. Depending on your income, you could be eligible for coverage through Medi-Cal or qualify for discounts through the Covered California marketplace.
Q: What Happens If I Don’t Choose?
A: If you’re covered through Medicare, you will likely continue with the same plan you were on. If you are on a plan through your employer or Covered California and your plan goes away, you may automatically get assigned to a plan offering comparable coverage at a similar price. Otherwise, you may be required to re-enroll each year.
Q: What Happens If I Don’t Have Coverage and Miss the Deadline?
A: If your job offers coverage but you miss the deadline, you can’t enroll until the following year unless you have a qualifying life event. You may be able to get a short-term plan, be eligible for Medi-Cal, or the Children’s Health Insurance Program (CHIP). The same is true for Covered California. If you miss your deadline to sign up for Medicare, you can enroll during the General Enrollment Period that runs from January 1 to March 31 every year. Your coverage, however, won’t start until July 1.
Q: What Is a Qualifying Life Event?
A: These are events that allow you to change, cancel, or enroll in new coverage outside of the open enrollment period, they include:
⦁ Getting married
⦁ Having a baby
⦁ Losing a job or experiencing a change to your income
⦁ A death in the family
⦁ Moving to a different ZIP code
⦁ Becoming a U.S. citizen
Q: How Can I Save Money on Coverage?
A: Make sure you apply for tax credits or cost-sharing reductions if you purchase a plan through Covered California. That can reduce what you pay.
Some health insurance plans offer discounts if you maintain a healthy weight, enroll in an exercise program, or take part in activities your company requests. There are other ways to save money:
⦁ Choose in-network doctors
⦁ Only visit the emergency room for true emergencies
⦁ Take advantage of covered health screenings: you may qualify to get preventive cancer screenings, diabetes screenings, HIV and STI tests, and many others at no cost
⦁ If you are given a prescription, ask if a generic version is available
Q: Can I Get Help Choosing the Right Insurance?
A: AltaMed has professionals dedicated to help you understand your health care options. They can provide you with:
⦁ Free one-on-one enrollment assistance over the phone
⦁ Bilingual-certified enrollment counselors
⦁ Information about a variety of health care options including:
⦁ Covered California
Make your appointment today by calling (877) 462-2582 or visit here to get started.
Learn other ways to get the most from your coverage, regardless of the plan you’re on. And remember, we’re here for you. Call with your questions about selecting coverage that can help your whole family grow healthy – in 2021 and for years to come.