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Guest Editorial: You can continue to count on Covered California

Posted: September 15th, 2017 | Calendar, Opinion & News Briefs, Editorial | No Comments

By Covered California Staff

With everything going on at the national level, it would not be surprising if some are a little confused about what’s happening with Covered California — the only place to get financial help to pay for health care coverage through the Affordable Care Act.

Here’s the bottom line: The Affordable Care Act is still the law of the land. Open enrollment in California begins on Nov. 1 and runs through Jan. 31, 2018.

That’s the main thing consumers need to know. Despite all the uncertainty swirling around, Covered California remains strong and stands ready to help Californians get the health coverage that best suits their needs.

Those who do not have health insurance can go to CoveredCA.com now and use the Shop and Compare Tool to see their options for 2018. Consumers can compare plans and benefits and find out if they are eligible for financial assistance to help bring the cost of coverage within reach.

Once the calendar hits Nov. 1, Californians can enroll online or click on the “Get Help” tab on the website to find a certified enroller near them if they want in-person assistance. Covered California has thousands of experts around the state ready to help people sign up for coverage. Consumers who qualify for Medi-Cal do not have to wait to sign up; they can get low-cost or no-cost health care right now.

Approximately 120,000 residents of San Diego County are already enrolled in a plan through Covered California and their renewal period will begin in October.

Consumers in the San Diego area will be able to choose from Blue Shield of California, Health Net, Kaiser Permanente, Molina Health Care and Sharp Health Care.

While Covered California has helped bring the state uninsured rate down from 17 percent in 2013, the year before the Affordable Care Act went into effect, to 7.1 percent by the end of 2016, a lot of work remains. Covered California is committed to getting everyone insured.

We all know people who have lived without insurance or with inadequate health care for too long.  It doesn’t have to be this way. Help is out there, and open enrollment is the time to sign up for life-changing care. Nearly 90 percent of Covered California enrollees qualify for some level of financial help, and health plans can cost less than a monthly cell phone bill.

Plus, Covered California plans all come with a patient-centered benefit design that allows members to access a wide variety of care that is not subject to a deductible, meaning they get more value from their coverage. These benefits mean that most outpatient services in Covered California’s Silver, Gold and Platinum plans are not subject to a deductible, including primary care visits, specialist visits, lab tests, X-rays and imaging. In addition, some Enhanced Silver plans have little or no deductible and very low copays, such as $3 for an office visit. Even consumers in Covered California’s most affordable Bronze plans are allowed to see their doctor or a specialist three times before the visits are subject to the deductible.

Covered California is also the first health exchange in the country to adopt benefit-design changes to improve access to high-cost specialty drugs. A vast majority of Covered California members will have their specialty drugs capped at $250 per month, per prescription, and the caps range from $150 to $500. That ensures they have affordable access to the medications they need to fight chronic conditions.

Covered California believes that health care coverage isn’t just about making insurance more affordable, it’s about doing things to make it easier for consumers to get the right care at the right time.

So if you know people who do not have health insurance — whether they are a family member, a friend or someone you just met — let them know about Covered California. Give them a call or send them a text. If they have questions, tell them how they can get answers from one of Covered California’s experts. The help is free and confidential.

Together we can build a healthier city and state. We can get people covered to help them overcome an illness or injury and give them the freedom to pursue their dreams.

—The health reform legislation (Patient Protection and Affordable Care Act) signed into law in March 2010 by President Obama, created state-based health insurance exchanges. States can choose to operate their own exchanges or participate in a multi-state exchange. California early on chose to operate its own exchange, now known as “Covered California.” Their mission is to increase the number of insured Californians, improve health care quality, lower costs, and reduce health disparities through an innovative, competitive marketplace that empowers consumers and small businesses to choose the health plan and providers that give them the best value. Visit coveredca.gov.

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