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What Does Health Care Reform Mean to You in Contra Costa County?

The Affordable Care Act (ACA) which is often called Health Care Reform takes effect January 2014. There are two major parts that will affect the way you can get coverage for yourself and your family. Medi-Cal will be expanded to cover more people, even childless adults, and insurance companies will be offering options for enrollment in state run exchanges. The State of California set up CoveredCA as a state run exchange or marketplace where you can purchase your health coverage.

Whether you're uninsured, or just want to explore new options, CoveredCA will give you more choice and control over your health insurance options. Enrollment in the state exchange (CoveredCA) starts in October 2013 for an effective date of January 2014.

CCHP (Contra Costa Health Plan) is one of 13 plans approved to offer coverage through CoveredCA.

CCHP was the very first Federally Qualified, State Licensed, and County Run HMO (Health Maintenance Organization) Health Plan in the United States. CCHP has two provider networks to choose from. Members can pick providers from the Contra Costa Regional Medical Center (CCRMC) and conveniently located clinics or choose a provider from our Community Provider Network (CPN) and many of the local hospitals. Celebrating 40 years in 2013, with over 120,000 members CCHP continues to be part of the health care solution, now and into the future.

CCHP Marketing department representatives can give you information on the different health coverage plans offered through CCHP and other options. Please call 800-211-8040 for more information.

There are 5 key facts that you should know about getting health coverage through CoveredCA:

  1. You may qualify for financial help from the government to buy health insurance and you should expect to pay at least a part of your healthcare coverage.
  2. You and/or your family members cannot be denied coverage due to any pre-existing conditions.
  3. Open Enrollment starts in October and you will be able to enroll in the plan of your choice over the phone or online at www.coveredca.com
  4. You could face a tax penalty if you are eligible to purchase health coverage and you don't do so during the Open Enrollment period.
  5. If you are low-income, you may qualify for expanded Medi-Cal coverage and not have co-payments or monthly premiums.

7 things you can do to get ready now:

  1. Learn about different types of health insurance. Through the CoveredCA, website you'll be able to choose and compare health plans to find the one that gives you the right balance of costs and coverage.
  2. Make sure you understand how insurance works, including deductibles, out –of- pocket maximums, co-payments etc. Read the definitions below to learn more about how insurance works and what it means to you and your family.
    • Co-payments: the amount you pay for services also called cost sharing.
    • Deductible: the amount you must pay for services before your health insurance pays each year.
    • Maximum out of pocket/out of pocket (MOOP or OOP): after you pay this amount for services, the insurance will pay all costs you incur that year without any copayments or cost-sharing from the patient.
  3. Start gathering basic information about your household income. Most people will qualify and get a break on costs, and you'll need income information to find out how much financial help you're eligible for. The help comes in the form of Federal Tax Credits which can pay all or a portion of your monthly premium. Some people may also qualify for Federal subsidies that will reduce the co-payments/cost sharing for services.
  4. Make a list of questions you have before it is time to choose your health plan. For example "Can I stay with my current doctor?" or "Will this plan cover my health costs when I'm traveling?"
  5. Set your budget. There will be different types of health plans to meet a variety of needs and budgets, and breaking them down by cost can help narrow your choices.
  6. Examine the plan designs carefully. Plans with lower monthly premiums usually will have higher co-pays, deductibles and maximum out of pocket costs.
  7. Explore current options if you are low income. You may be able to get help with insurance now, through existing programs or changes that are in effect already (see the information below).

WHAT TO DO IF YOU NEED COVERAGE NOW AND ARE LOW INCOME:

The Low Income Health Plan in Contra Costa County can help individuals/families get health care coverage through CCHP. This health care coverage option has a low monthly cost and no co-payments for services. Individuals and Families qualify according to income and assets. Call 800-771-4270 for information on eligibility for this program.

You may also be eligible for Medi-Cal. Call the Health Care Access Center at 1-800-709-8348 for more information.

WHAT IF YOU NEED COVERAGE BEFORE 2014?

If you have been turned down because of a pre-existing condition you could be eligible through the Managed Risk Medical Insurance program. For information visit their website at www.mrmib.ca.gov

If you are not yet 26 and your parents have health insurance, under the Affordable Care Act, you can stay on your parent's health coverage.

If you are over 65 or disabled you may be able to apply for health coverage through Medicare. For information see the Medicare website at www.Medicare.gov