Medi-Cal Eligibility and Covered California – Frequently Asked Questions
Bumalik sa Medi-Cal FAQs 2014
Sa ibaba makikita mo ang mga madalas itanong para sa kasalukuyan at potensyal na mga tatanggap ng saklaw ng Medi-Cal. Kung hindi ka makakita ng sagot sa iyong tanong, mangyaring makipag-ugnayan sa iyong lokal na tanggapan ng county mula sa aming pahina ng Mga Listahan ng County o mag-email sa amin sa Medi-Cal Makipag-ugnayan sa Amin.
Sakop ng California
1. What is Covered California?
Covered California is the new marketplace that makes it possible for individuals and families to get free or low- cost health insurance through Medi-Cal, or to get help paying for private health insurance.
Our goal is to make it simple and affordable for Californians to get health insurance. Covered California is a partnership of the California Health Benefit Exchange and the California Department of Health Care Services.
2. How can Covered California help me?
Covered California can help you choose a private insurance plan that meets your health needs and budget. We offer some of the state’s best known health plans, and some regional or local plans too.
We can explain the costs and benefits of health insurance plans clearly, so you can compare the different choices available to you. You will know exactly what you’re getting and how much you have to pay before you choose your plan.
3. I am a federally recognized American Indian or an Alaska Native. How can Covered California help me?
Kung ikaw ay isang kinikilalang pederal na American Indian o isang Katutubong Alaska, maaari kang maging karapat-dapat para sa:
- Libre o murang insurance
- Premium na tulong
- Nabawasan ang out-of-pocket na gastos
- Mga espesyal na buwanang panahon ng pagpapatala
Makakakuha ka rin ng mga serbisyo mula sa pinondohan ng Indian Health Services' tribal health Programa o Indian health Programa.
Siguraduhing kumpletuhin ang Attachment A at ipadala ito kasama ng iyong patunay ng dokumentong pamana ng Katutubong Amerikano o Katutubong Alaska. Maaari mong gamitin ang mga sumusunod na dokumento upang magbigay ng patunay ng iyong pamana ng Native American Indian o Native Alaskan:
- Tribal enrollment card o
Certificate of degree of Indian blood (CDIB) mula sa Bureau of Indian Affairs.
4. Maaari ba akong makakuha ng health insurance sa pamamagitan ng Covered California?
Ang sinumang taga-California ay maaaring makakuha ng segurong pangkalusugan sa pamamagitan ng Covered California kung siya ay isang residente ng estado at hindi makakakuha ng abot-kayang segurong pangkalusugan sa pamamagitan ng isang trabaho.
Ang mga aplikante ay maaaring maging kwalipikado para sa isang libre o murang Planong Pangkalusugan, o para sa tulong pinansyal na maaaring magpababa sa halaga ng mga premium at co-pay. Ang halaga ng tulong pinansyal ay batay sa laki ng sambahayan at kita ng pamilya. Kwalipikado ang mga aplikante kung ang kanilang kita ay nakakatugon sa mga limitasyon ng kita.
5. When will I be able to get coverage through Covered California?
Magsisimula ang Covered California sa pagpapatala sa Okt. 1, 2013, para sa pagsakop na magkakabisa sa Ene. 1, 2014. Ang open-enrollment period para sa coverage sa 2014 ay tatakbo mula Oktubre 1, 2013, hanggang Marso 31, 2014. Kung ikaw ay karapat-dapat para sa Medi-Cal, ang bukas na panahon ng pagpapatala ay hindi mahalaga.
6. I am currently enrolled in Medi-Cal. Can I get health insurance through Covered California?
Kung magbabago ang iyong kita sa loob ng taon o sa iyong taunang pag-renew, maaari kang maging kwalipikado para sa iba pang insurance sa kalusugan at tulong sa premium sa pamamagitan ng Covered California.
7. How do I apply through Covered California?
Maaari kang mag-aplay para sa health insurance sa pamamagitan ng Covered California sa mga sumusunod na paraan:
- Online: Bisitahin ang www.CoveredCA.com. Nagbibigay kami ng impormasyon tungkol sa bawat plano ng segurong pangkalusugan, na ipinaliwanag sa malinaw at simpleng mga termino.
- Sa pamamagitan ng telepono: Tumawag sa Covered California sa (800) 300-1506 (TTY: (888) 889-4500). Maaari kang tumawag mula Lunes hanggang Biyernes, 8 am hanggang 6 pm at Sabado, 8 am hanggang 5 pm Libre ang tawag!
- Sa pamamagitan ng fax: I-fax ang iyong aplikasyon sa (888) 329-3700.
- By mail: Mail the Covered California application to:
Covered California
P.O. Box 989725
West Sacramento, CA 95798-9725
- In person: We have trained Certified Enrollment Counselors or Certified Insurance Agents who can help you. Or you can visit your county social services office. This help is free! For a list of places near where you live or work, visit www.CoveredCA.com or call (800) 300-1506 (TTY: (888) 889-4500).
8. What will happen after I apply for health coverage?
You will receive a letter within 45 days to tell you which program you and your family members qualify for. If you don’t hear from us, please call us at (800) 300-1506 (TTY: (888) 889-4500).
9. What health insurance is offered through Covered California?
You will have a wide variety of health plans to choose from. Health insurance companies cannot refuse to cover you because you have been sick before or could not get coverage.
Covered California offers four groups of private health insurance plans: platinum, gold, silver, and bronze, plus a minimum coverage plan.
Each group offers a different level of coverage, from high to low. Health insurance plans that cover more of your medical expenses will usually have a higher premium but allow you to pay less when you receive medical care.
Platinum plans have the highest premium, but they pay 90% of your health care expenses. Gold plans pay pay 80% and silver plans pay 70% of your health care expenses. Bronze plans have the lowest premium but pay just 60% of covered health expenses.
If you qualify for Medi-Cal, the coverage and costs are different and may be free for you.
10. I have a pre-existing condition. Can I get health insurance through Covered California?
Oo, maaari kang makakuha ng segurong pangkalusugan anuman ang anumang kasalukuyan o nakaraang kondisyon ng kalusugan. Simula sa 2014, karamihan sa mga plano sa segurong pangkalusugan ay hindi maaaring tumanggi na sakupin ka o singilin ka ng higit pa dahil lang sa mayroon kang dati nang kondisyong pangkalusugan.
11. I have a disability. Can I get health insurance through Covered California?
Hindi ka maaaring tanggihan batay sa isang dati nang kundisyon. Ang pagiging karapat-dapat ay batay sa kita, hindi sa katayuan sa kalusugan.
12. Will I be able to use my new Covered California health insurance plan right away?
Ang Covered California Planong Pangkalusugan ay nagsimulang magbigay ng mga serbisyo noong Enero 1, 2014.
13. When someone enrolls in a health insurance plan during open enrollment but after Jan. 1, 2014, will the effective date be Jan. 1, or is it subject to the actual enrollment date?
If you enroll in a Covered California plan before Dec. 15, 2013, you can be eligible to have coverage that starts on Jan. 1, 2014. You will also need to pay your share of the premium before January. During the last three months of the initial Covered California open-enrollment period (from Jan. 1, 2014, through March 31, 2014), an individual who submits a completed application, receives an eligibility determination and makes a plan selection by the 15th of each month will receive a coverage-effective date of the first day of the following month, as long as the person’s full premium payment is received. For example, someone who has enrolled in a Covered California health insurance plan by Jan. 15, 2014, will have coverage beginning Feb. 1, 2014 if they pay their share of premium.
14. What is the difference between Medicare and Covered California’s open enrollment?
Sa kasalukuyan, mayroong dalawang bukas na panahon ng pagpapatala na nangyayari sa parehong yugto ng panahon, na maaaring magdulot ng ilang kalituhan sa mga residente ng California.
Sakop ng California
- The Covered California exchange will permit individuals to enroll in health plan coverage or Medi-Cal during the initial enrollment period from October 1, 2013, to March 31, 2014, and thereafter during an open enrollment period that will begin on October 15 and last through December 7 annually. People who want to enroll in a health plan or find out if they are newly eligible for Medi-Cal, can call Covered California at (800) 300-1506 or visit www.CoveredCA.com for information.
Medicare Open Enrollment
- Ang bukas na panahon ng pagpapatala ng Medicare ay Oktubre 15 hanggang Disyembre 7 para sa lahat ng taong may Medicare. Maaaring baguhin ng mga kliyente Medicare ang kanilang Medicare Planong Pangkalusugan at saklaw ng inireresetang gamot, na magkakabisa sa Enero 1, 2014. Ang mga taong may Medicare ay maaaring tumawag sa (800) Medicare o bisitahin ang www.medicare.gov para sa impormasyon ng plano. Kung ang tao ay nasiyahan sa kanilang kasalukuyang plano, hindi nila kailangang gumawa ng anuman.