You Need Health Care Coverage Right Now. Let Us Help.

August 13, 2020

For a  variety of reasons many people are now without health care coverage – at a time when there’s a public health crisis raging all around us. Even if you take every precaution to stay safe, now is not the time to be without dependable health care coverage. 

This is a brief rundown of your options. It is not a substitute for advice, and of course, things can change rapidly. That’s why your best bet is to contact us so we can give you personalized advice about your options. Read on to learn more.

 

Getting Insurance Through Medi-Cal

Section 1

Medi-Cal is low- or no-cost essential coverage for some of our state’s most vulnerable residents, including those who are:
⦁    Below a certain income level
⦁    Blind
⦁    65 or older
⦁    Disabled
⦁    Under 21
⦁    Pregnant
⦁    In a skilled nursing or intermediate care home
⦁    On refugee status for a limited time, depending on how long you have been in the United States
⦁    A parent or caretaker relative of an age-eligible child
⦁    Have been screened for breast and/or cervical cancer 

If you are eligible for Medi-Cal, you can apply at any time at the Covered California website (also called the exchange). You can choose from plans offered by well-known companies such as Anthem-Blue Cross and Heath Net, and you could also receive public benefits.

Anyone can apply for Medi-Cal, but your immigration status may complicate eligibility or the level of help you can receive.

 

Getting Insurance Through Medicare

Section 2

Medicare is for seniors 65 years or older, regardless of their income, medical history, or health status. It also covers younger people with disabilities and people with permanent kidney failure who require dialysis or a transplant. 

Medicare covers many services, including hospitalizations, doctor visits, medications, and even skilled nursing facilities. However, Medicare isn’t just one type of plan:

⦁    Medicare Part A and Part B cover many typical health needs, including doctor visits, preventive services, home health visits, inpatient hospital stays, and more. 
⦁    Medicare Part C, or Medicare Advantage, allows recipients to also enroll in a private health insurance plan to cover gaps in care and keep expenses down.
⦁    Medicare Part D covers outpatient prescription drugs. It is a partnership with private plans.

Most people with Medicare are very satisfied with it. Still, care is not always free, and traditional Medicare does not cover benefits like eyeglasses, dental services, hearing aids, and long-term care. And, as you can see, enrolling in the right combination of plans can be confusing.

 

Getting Insurance Through Covered California

Section 3

If you had a job that provided health care coverage but lost it, or had your hours cut and no longer qualify for insurance through work, you could be eligible to get a new plan through Covered California, the state’s insurance exchange. Depending on your income level, you may even qualify for assistance to help you pay for your monthly premiums (but you have to go through Covered California to get it).

If you have experienced one of the following qualifying life events, you have 60 days to apply for a new plan and assistance through Covered California:

⦁    Marriage or divorce
⦁    Loss of Medi-Cal or job-based coverage
⦁    You turn 26 and age out of your parents’ coverage
⦁    Have or adopt a baby
⦁    A death in the family
⦁    Move to a new ZIP code
⦁    Becoming a U.S. citizen

This year, because of the Covid-19 pandemic, California has extended the Special Enrollment period until August 31, to help more people get covered.

If you haven’t had one of the qualifying life events listed above, you can still purchase a plan through Covered California during the regular Open Enrollment period. 

 

Getting Insurance Through COBRA

Section 4

If you lose access to your employer-sponsored health insurance, you may be offered COBRA (the Consolidated Omnibus Budget Reconciliation Act, but it is almost always referred to as COBRA). COBRA lets you keep the plan you were on through your employer, but now, instead of your boss covering part of the bill, you are responsible for the entire monthly premium. COBRA lets you continue your plan for up to 18 months.

Usually, getting your plan through COBRA is very expensive, depending on your plan, if your family was covered, and how much your employer paid. However, it may be worthwhile to consider it if you (or someone covered by the plan) require complex medical care and if:

⦁    Your plan was extremely generous
⦁    You have already met your calendar-year deductible or out-of-pocket maximum
⦁    Your health could be jeopardized by a gap in care or not being able to access specific treatments

 

Not Sure About the Best Choice?

Section 5Health care coverage can be confusing, but it doesn’t have to be. Trust the experts at AltaMed to make it simple for you to select and enroll in the plan that’s the best fit for you and your family’s needs. There’s no cost and no obligation. For more information or to connect with us, visit our Health Insurance Resource page today!
 

 

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What to Do If You’ve Been Told You Need Surgery

February 02, 2020

If you’re a patient, there’s no such thing as ‘routine surgery.’ All surgical procedures, ranging from common surgeries like the removal of your appendix or wisdom teeth, to a C-section or complex heart bypass operation, contain some risk. Even though your medical team has your best interests at heart, it’s natural to be scared if you’re told you need surgery. In most cases the surgery is elective – that is, it’s not an emergency and even if it's a lifesaving surgery – you still have the option of getting a second opinion or even refusing.

If you’ve been told you need surgery and aren’t sure if it’s the right option, this information can help you make the right choice.

 

Ask the Right Questions

With the doctor

A good doctor will want their patients to feel comfortable. Now is the time to take an active role in your health. It’s part of your doctor’s job to listen to you and provide honest answers to your questions, especially when it comes to making choices about your care.

  1. Why is the operation being recommended?
  2. What other treatments are available?
  3. What are the benefits and how long will they last?
  4. What are the potential complications?
  5. What happens if I decide to delay the surgery?
  6. How will I be affected if I refuse the surgery?
  7. How many of these surgeries have you performed?

If possible, ask the doctor or their staff to put the answers in writing. Make sure you can understand what you’re being told. You always have the right to have a family member, interpreter, or other trusted individual with you at this appointment.

 

Find Out About Costs and Coverage

Ask the Right Questions

Make sure the surgery is covered by your health plan and ask if they can tell you how much you could expect to pay (both overall and out-of-pocket), what affects those charges, and how much they could differ. Depending on your plan, it should be easy to see another doctor for a second opinion. To avoid unexpected charges, verify with your insurance customer service first.

 

Get a Second Opinion

Get a Second Opinion

Even though doctors go through years of schooling and training, many medical issues aren’t black and white, and there can be many treatments available. Two doctors can often see things differently, which is why a second opinion is important.

As mentioned above, your first step should be checking with your health plan. If possible, see a doctor at another hospital or health system (if it’s covered) – you may benefit by seeing someone with completely different training and experience.

Before your second opinion, get copies of all of the documents, scans, X-rays, and appointment notes relating to your condition. Even if your doctor’s office offers to email or fax the documents, your best bet is to get hard copies and carry them with you to your visit. That way the new doctor has all of the information and won’t need to send you for additional tests. This will save you time and money.

 

Research the Surgeon

Research the Surgeon

You’ve already asked questions about the surgery; now it’s time to learn more about the doctor performing your surgeon. Start by asking your primary care physician for their opinion. You can also learn a lot by searching online. No, there’s still not a Yelp for doctors, but sites like HealthGrades and AMA Doctor Finder have important information about board certification, years of experience, hospital ratings, sanctions and malpractice, and all the other information you need to make an informed decision.

 

Ask for an Advocate

Depending on your condition, you may qualify for an advocate or other services through your hospital or your health coverage plan. In some cases, an advocate can provide you with a list of surgeons in your area, as well as general information about your treatment options. Advocates may also be able to coordinate after-care, such as necessary prescriptions, transportation home, follow-up visits, and occupational or physical therapy. Services vary by hospital and plan; talk to your doctor and your insurance customer service to learn more.

 

Once You’ve Made Your Decision, Let It Go and Start Getting Ready

Once You’ve Made Your Decision, Let It Go and Start Getting Ready

Managing a chronic condition, injury, or illness can be a big source of stress. Concentrate on the fact that you’ve done your homework and made a decision to improve your life. Try to remain positive and stay committed to your health. You may even take time to revisit some long-term health goals – for example, getting to a healthy weight or quitting smoking, both of which can greatly improve your odds for a successful health outcome.

Also, get your home ready for your release, especially if you expect to be mobility-challenged for a while. Make sure you have plenty of supplies on hand, including your medications, meals that don’t require much preparation, medical equipment you may needs (crutches, a walker, bandages or dressings, a raised toilet seat), and items of convenience and comfort, like tissues, slippers, heating pads, entertainment, or even a handy grabber stick. Relax and don’t rush your recovery – you’ve only got one chance to get it right!

 

Grow Healthy with Complete Care from AltaMed

January 02, 2020

AltaMed was established in 1969 – in a much different form than what you know today. 

AltaMed President and CEO Cástulo de la Rocha remembered seeing the only health clinic in his neighborhood with lines around the block and knew there had to be a better way for people to get the care they need. And from humble beginnings as the East LA Barrio Free Clinic, AltaMed has continued to grow, adding more coverage and services to serve more people.

Even though we’ve grown from one location to more than 30 health centers throughout Southern California, and have a large network that includes top doctors, some things haven’t changed. We’re still committed to bringing personal, modern care to members of communities that previously haven’t had many options for health services. We staff our facilities with compassionate doctors and staff who speak your language and understand your culture.  And we believe that for communities to grow healthy, we need to advocate for services and resources beyond health care. 

Take a look at some of our core services, then call and make an appointment at (888) 499-9303.

 

Primary Care

doctor and nurse talking in a consultory

Seeing a primary care physician is the first step of your journey to good health. Go to your primary care doctor for routine health screenings and immunizations. And, if you think you may be sick or something is wrong, they can help you get the care you need, even if they have to refer you to a specialist.

We want you to feel comfortable seeing your primary care doctor, which is why we have bilingual doctors and staff. With our doctor finder tool, you can even search for a doctor based on their gender and location. We want nothing to come between you and the care you need.

 

Women’s Health Care

Doctor and nurse talking to a senior woman

Women have unique health care needs. For a variety of reasons, they are also more likely to suffer heart disease, stroke, certain types of cancer, and even some mental health conditions. That’s why they need doctors who understand what it takes to keep them mentally and physically healthy – like the caring doctors who are part of AltaMed Women’s Health Services.

We offer care and services for every stage of a women’s life, including mammograms, family planning, reproductive health, and more. Make an appointment today to learn about age-appropriate screenings – they could save your life!

 

Pediatrics

Pediatrician checking a girl's hear

Your kids depend on you to keep them healthy, and you can depend on AltaMed. Bring your child to see our pediatricians for routine visits. We also offer immunizations that may be available to you and your child for free. 

 

Behavioral Services

Psychologist in a consultation with an elderly man

Life has its ups and downs, and it’s normal to feel sad or anxious once in a while. But if you frequently feel depressed, angry, or like you need to drink or take drugs to cope, it’s time to see a professional. Our compassionate Behavioral Health team can make sure you get the treatment you need. It’s completely confidential, and we can help you get on the road to feeling like yourself again.

 

AltaMed PACE

Elderly eating at PACE canteen

As we age, it’s normal to need a little extra care. For seniors with complex medical needs who aren’t ready for assisted living, AltaMed PACE can help keep them healthy and independent at home. AltaMed PACE is the Program of All-Inclusive Care for the Elderly, and it includes coordinated medical care, social services, transportation, and meals, all in a friendly neighborhood setting that seniors (and caregivers) love. Some seniors may even qualify for more assistance at home. AltaMed PACE may be covered at 100% for Medicare-eligible seniors. Contact us to learn more (877) 499-9303.

 

Dental Services

Woman at dentistry room

We want to help you keep your teeth healthy and bright for life! That means starting early and getting regular checkups, X-rays, and cleanings. 

Bring your entire family to AltaMed for dental services. Kids should start seeing the dentist within six months of developing their first tooth. By visiting the dentist twice a year, as recommended by the American Dental Association, you may be able to keep your teeth for your whole life! Other services include fillings, root canals, crowns, and emergency dentistry.

 

HIV/AIDS Care and Prevention

Guys holding the pride flag

There are more ways than ever to prevent and treat HIV and AIDS. But that doesn’t mean we can give up the fight! We’re dedicated to providing the resources our members need to protect their status and stay healthy, including rapid testing, prevention, and educational services.

For those who are HIV positive, we take a whole-person approach to care. We support our members and their loved ones with a full range of services, such as pharmacy, primary care, behavioral health, and care management.

 

Get Started with AltaMed!

Doctor hugging her little patient

There’s so much we can do to help you grow healthy – and it all starts with an appointment. We accept many different health plans, including Medicare, Medi-cal, and many commercial plans. If you’d like to learn more about your health plan options, we can help with that, too. We look forward to seeing you and helping you live a long, healthy life.