Medi-Cal Eligibility and Covered California – Frequently Asked Questions
下面您将看到当前和潜在的 Medi-Cal 保险接受者最常问的问题。 如果您没有找到问题的答案，请通过我们的“县列表”页面联系您当地的县办公室，或通过Medi-Cal 联系我们发送电子邮件给我们。
全保加州
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?
如果您是联邦政府认可的美国印第安人或阿拉斯加原住民，您可能有资格获得：
- 免费或低成本保险
- 保费协助
- 减少自付费用
- 每月特别注册期
您还可以获得印度健康服务局资助的部落健康计划或印度健康计划的服务。
请务必填写附件 A，并将其连同您的美洲原住民或阿拉斯加原住民血统证明文件一起发送。 您可以使用以下文件来证明您的美洲印第安人或阿拉斯加原住民血统：
- 部落登记卡或
印第安人事务局颁发的印第安血统证书 (CDIB)。
4.我可以通过全保加州 (Covered California) 获得健康保险吗？
如果加州居民并且无法通过工作获得负担得起的健康保险，任何加州人都可以通过加州全保获得健康保险。
申请人可能有资格享受免费或低成本的医疗计划，或获得可降低保费和共付费用的经济援助。 经济援助的数额取决于家庭规模和家庭收入。 如果申请人的收入符合收入限制，则申请人符合资格。
5. When will I be able to get coverage through Covered California?
加州全保将于 2013 年 10 月 1 日开始接受报名，保险将于 2014 年 1 月 1 日生效。 2014 年保险开放注册期为 2013 年 10 月 1 日至 2014 年 3 月 31 日。 如果您符合 Medi-Cal 的资格，则开放注册期并不重要。
6. I am currently enrolled in Medi-Cal. Can I get health insurance through Covered California?
如果您的收入在年内或年度续保时发生变化，您可能有资格通过加州全保获得其他健康保险和保费援助。
7. How do I apply through Covered California?
您可以通过以下方式通过全保加州 (Covered California) 申请健康保险：
- 在线：访问www.CoveredCA.com 。 我们提供有关每种健康保险计划的信息，并以清晰简单的术语进行解释。
- 通过电话：致电加州全保 (800) 300-1506（TTY：(888) 889-4500）。 您可以在周一至周五上午 8 点至下午 6 点以及周六上午 8 点至下午 5 点致电 通话免费！
- 通过传真：将您的申请传真至（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?
是的，无论当前或过去的健康状况如何，您都可以获得健康保险。 从 2014 年开始，大多数健康保险计划不能仅仅因为您有既往的健康状况而拒绝为您提供保险或向您收取更多费用。
11. I have a disability. Can I get health insurance through Covered California?
我们不能以您先前存在的状况为由拒绝您。 资格取决于收入，而不是健康状况。
12. Will I be able to use my new Covered California health insurance plan right away?
加州全保健康计划于 2014 年 1 月 1 日开始提供服务。
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?
目前，同一时期有两个开放注册期，这可能会引起加州居民的困惑。
全保加州
- 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.
医疗保险开放注册
- 针对所有参加 Medicare 的人员，Medicare 的开放注册期为 10 月 15 日至 12 月 7 日。 医疗保险客户可以更改他们的医疗保险计划和处方药保险，该更改将于 2014 年 1 月 1 日生效。 享受医疗保险的人可以致电 (800) MEDICARE 或访问 www.medicare.gov 获取计划信息。如果人们对当前的计划感到满意，他们就不需要做任何事情。