Medi-Cal Eligibility and Covered California – Frequently Asked Questions
下面您將找到針對目前和潛在的加州醫療補助健康保健計劃承保受益人的最常見問題。 如果您沒有找到問題的答案，請透過我們的縣清單頁面聯絡您當地的縣辦公室，或透過加州醫療補助健康保健計劃 聯絡我們 向我們發送電子郵件。
覆蓋加州
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?
如果您是聯邦認可的美國印第安人或阿拉斯加原住民，則可能符合以下條件：
- 免費或低成本保險
- 保費協助
- 減少自付費用
- 特別每月入學期間
您也可以從印第安健康服務部資助的部落健康專案或印第安健康專案獲得服務。
請務必填寫附件 A 並將其與您的美國原住民或阿拉斯加原住民遺產文件一起發送給它。 您可以使用以下文件提供您的美洲原住民印第安人或阿拉斯加原住民遺產的證明：
- 部落入學卡或
印度事務局頒發的印度血文學位證書（CDIB）。
4 .我可以透過加州全保獲得健康保險嗎？
如果任何加州人是州居民並且無法透過工作獲得負擔得起的健康保險，則他或她可以透過加州全保獲得健康保險。
申請人可能有資格獲得免費或低成本的健康計劃，或獲得可降低保費和自付費用的財務協助。 經濟援助金額取決於家庭人數和家庭收入。 申請人如果他們的收入符合收入限制，則符合資格。
5. When will I be able to get coverage through Covered California?
加州承保範圍將於 2013 年 10 月 1 日開始登記，承保範圍將於 2014 年 1 月 1 日生效。 二零一四年的開放報名期將由二零一三年十月一日至二零一四年三月三十一日。 如果您符合加州醫療補助健康保健計劃的資格，開放報名期限並不重要。
6. I am currently enrolled in Medi-Cal. Can I get health insurance through Covered California?
如果您的收入在一年中或年度續保時發生變化，您可能有資格透過加州全保獲得其他健康保險和保費援助。
7. How do I apply through Covered California?
您可以透過以下方式透過 Covered California 申請健康保險：
- 在線：訪問網站 CoveredCA.com。 我們提供有關每個健康保險計劃的信息，以清晰簡單的術語解釋。
- 透過電話：致電 Covered California，電話 (800) 300-1506（ TTY ：(888) 889-4500）。 您可以致電週一至週五，上午 8 點至下午 6 點和星期六上午 8 點至下午 5 點。 通話是免費的！
- 傳真：將您的申請傳真至 (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，無論當前或過去的任何健康狀況，您都可以獲得健康保險。 從 2014 年開始，大多數健康保險計劃只是因為您已存在的健康狀況而拒絕支付您的保障或向您收取更多費用。
11. I have a disability. Can I get health insurance through Covered California?
根據先前存在的條件，您不能被拒絕。 資格取決於收入，而不是健康狀況。
12. Will I be able to use my new Covered California health insurance plan right away?
加州承保健康計畫於 2014 年 1 月 1 日開始提供服務。
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，有兩個開放註冊期同時發生，這可能會給加州居民帶來一些困惑。
覆蓋加州
- 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.
聯邦醫療保險公開報名
- 聯邦醫療保險的開放投保期為 10 月 15 日至 12 月 7 日，適用於所有擁有聯邦醫療保險的人士。 聯邦醫療保險客戶可以更改其聯邦醫療保險健康計劃和處方藥承保範圍，該政策將於 2014 年 1 月 1 日生效。 擁有聯邦醫療保險的人士可以致電 (800) 聯邦醫療保險或訪問 www.medicare.gov 了解計劃資訊。如果該人對他們當前的計劃滿意，他們不需要做任何事情。