countdown to the affordable care act

Whether you call it the Affordable Care Act (ACA), Obamacare, or healthcare reform, good changes are coming to health care coverage soon. The new law:

  • Expands coverage for millions of Americans
  • Ensures people receive the most common preventive care services at no cost with no deductible
  • Ends denial of health insurance and higher premiums
    based on pre-existing conditions (when coverage is
    purchased during open enrollment periods)
  • Requires most people to get health insurance

So what does this mean for you and your family?



You’re Secure and Covered.

Here are some answers to the questions we’ve been asked most often.

1. I keep hearing the dates October 1 and January 1 mentioned. What’s the difference? What do I need to know?

October 1, 2013, is the date California begins allowing Californians to purchase health insurance through healthcare exchanges. California’s exchange program is Covered California. The program is set up for legal residents of California who do not have access to affordable health insurance through their employer or another government program. The purpose is to let individuals compare available plans and purchase the one that is best for themselves and their families.

By January 1, 2014, most Americans are required to have health insurance. Coverage can include employer-provided insurance, coverage you buy on your own, Medicare, or Medi-Cal.

2. I have Medi-Cal or Healthy Way LA. What happens to my coverage?

Here’s what you need to know if you are currently insured by Medi-Cal, Medicare, or Healthy Way LA:

  • If you currently have Medi-Cal, you will continue to have Medi-Cal. You must renew your coverage each year just as you do now.
  • On January 1, 2014, Healthy Way LA will become Medi-Cal. If you currently have Healthy Way LA Matched, you will receive a letter in the mail during October explaining the changes you will see. Look for this letter. You will have the option to keep your same doctor.
  • If you currently have Medicare, you can keep your Medicare coverage. You will probably see many of your costs lowered.

If you already have Medi-Cal, Healthy Way LA Matched, or Medicare, “You’re Secure and Covered!”

3. I don’t have coverage now. What do I do?

You need to get insurance by January 1, 2014.

There are many options. Your eligibility for different programs will depend on your income and citizenship or residency status. We can walk you through these options and help you make the best decision for yourself and your family.

The exchanges are designed for individuals who are legal residents, do not qualify for Medi-Cal, and are not covered by an employer’s plan. We can help you determine which programs you qualify for and help you sign up.

Here are the basics:

If you are an individual -

Making less than $15,856 annually You may qualify for Medi-Cal
Making $15,856 to $28,725 annually You may qualify for tax credits that lower your monthly premium and assistance paying out-of-pocket costs and co-pays
Making $28,725 to $45,960 annually You may qualify for tax credits that lower your monthly premium
Making over $45,960 annually You do not qualify for assistance, but you can still purchase health insurance through the Covered California exchange

If you are a family of four –

Making less than $32,499 annually You may qualify for Medi-Cal
Making $32,499 to $58,875 annually You may qualify for tax credits that lower your monthly premium and assistance paying out-of-pocket costs and co-pays
Making $58,875 to $94,200 annually You may qualify for tax credits that lower your monthly premium
Making over $94,200 annually You do not qualify for assistance, but you can still purchase health insurance through the Covered California exchange

You must enroll through Covered California to be eligible for the tax credit.

Open enrollment in Covered California begins October 1, 2013, and runs through March 31, 2014. You should get coverage by December 15, 2013, to ensure you are covered by January 1, 2014.

Don’t Wait. Sign-Up Is Easy.

Do you have questions? We can help.

We offer enrollment assistance whether you need help with Medi-Cal or Covered California. Sign-up is easy.

Call us today, and make sure “You’re Secure and Covered.”

Call Nelson Samayoa
(213) 747-5542 ext 3220

Or visit the Managed Care office, next to the main lobby.