Beruflich Dokumente
Kultur Dokumente
The Uninsured
1 out of 5 children and adults in LA County have no insurance
Children Parents Adults without children Workers Our Neighbors Our Friends Our Own Families
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Medi-Cal
Remaining Uninsured
You can be excused if: Cannot afford coverage Do not file Taxes Your religion does not allow it. Native Americans, Incarcerated People and the Undocumented
More people with coverage means lower costs for everyone Know the facts:
If full time (not part-time) employees go into Covered CA, the employer must pay a tax penalty.
The penalty only occurs if the employer has 30 or more full time employees.
<100% 1 2 3 4 5 6 7 8
138%
200%
250%
300%
400%
$45,960 $62,040 $78,120 $94,200 $110,280 $126,360 $142,440 $158,520
401% & up
$45,961 + $62,041 + $78,121 + $94,201 + $110,281 + $126,361 + $142,441 + $158,521 +
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<$11,490 $15,856
$15,971
$21,559 $27,147
$22,980
$31,020 $39,060
$28,725
$38,775 $48,825
$34,470
$46,530 $58,590
<$15,510 $21,404
<$19,530 $26,951 <$23,550 $32,499
$32,735
$38,322 $43,910 $49,498 $55,086
$47,100
$55,140 $63,180 $71,220 $79,260
$58,875
$68,925 $78,975 $89,025 $99,075
$70,650
$82,710 $94,770 $106,830 $118,890
<$27,570 $38,047
<$31,590 $43,594 <$35,610 $49,142 <$39,630 $54,689
Adults do not have to have children in Medi-Cal Income level goes up Former foster youth eligible up to age 26
Covered California
Helps make comparing, applying for and purchasing coverage easy.
Enroll as soon as October 2013. Coverage will start as soon as January 2014
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Whose Eligible?
Citizen and Lawfully Present Resident California Resident Household income above 138% financial assistance 139% - 400% Dont have public coverage (i.e. Medi-Cal) Cannot have employer coverage unless
Health Plan pays less than 60% Employees share of premium exceeds 9.5% of household income (not dependent share)
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Benefits
10 essential health benefits: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health & substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including dental and vision care
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Premiums
Based On Not Based On
Age Household Size Region Health Plan & Benefit Level Selected
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Paid by the health plan vs. the consumer Tiers Bronze Silver Gold Health Plan 60% 70% 80% Consumer 40% 30% 20%
High
Low
85%
70%
15%
30%
Platinum
90%
10%
Minimum Plan: for those under age 30 (no premium assistance & higher out of pocket costs)
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Bronze
Preventive
Primary Care Specialty Care Urgent Care Emergency Generic Medication Lab Testing X-Ray Deductible
Silver*
Gold
Platinum
$0
$4 - $45 $6-$65 $8 - $90 $25 - $250 $4 - $25 $6 - $45 $10-$65
$0
$45 $65 $90 $250 $25 $45 $65
$0
$25 $50 $50 $150 $5 $25 $40
$5000
$6,350 $12,700
$2000
$6,350 $12,700
None
$6,350 $12,700
None
$4,000 $8,000
o Estimated premium: $783 per month o Tax credit: $374 per month o Family pays: $409 per month
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CoveredCA.com
Benefitscal.org
(Medi-Cal & other Social Service)
County Offices
Improving Medicare
Increased coverage for wellness and preventative care. One free wellness visit per year. Covers more preventative services
Provides discounts on brand name and generic drugs while you are in the Part D coverage gap.
Closes the Part D coverage gap by 2020. Medicare Beneficiaries DO NOT have to purchase new Coverage
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Get Involved!
Talk with family, friends, and community members
For more Information:
Kaiser Family Foundation: healthreform.kff.org Health Reform website: www.healthcare.gov Covered California: http://www.coveredca.com/ La Opinion http://www.laopinion.com/lasaludempiezaaqui Univision Univision.com/saludaqui Telemundo http://www.telemundo52.com/secciones-especiales/asegurate
Questions?
Sonya Vasquez - Community Health Councils
sonya@chc-inc.org ~ (323) 295-9372 www.chc-inc.org www.facebook.com/CommunityHealthCouncils https://twitter.com/chcinc http://letsallgetcovered.org/
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