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
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
- 65 or older
- Under 21
- 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
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
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
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?
Health 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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