The Basics of Covered California
Covered California helps Californians find the healthcare coverage they need to protect themselves and their loved ones. The coverage this marketplace provides takes effect January, 2014. Part of the State of California, Covered California provides the tools consumers need to shop for health insurance; in some cases, Covered California offers financial assistance to make coverage more affordable. Covered California also offers a wide range of plans to fit almost every financial and health need.
Essential Health Benefits
The Affordable Care Act requires all health plans provide a comprehensive packages of vital items and services known as Essential Health Benefits. These benefits fit into ten categories:
- Ambulatory patient services, which is care rendered without admission to a hospital
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance abuse services
- Prescription drugs
- Rehabilitative services and devices
- Laboratory tests
- Preventive and wellness services and chronic disease management
- Pediatric services that include dental and vision care
Four Levels of Coverage
Starting in January 2014, Covered California will provide four levels of coverage: Bronze, silver, gold, and platinum. Premium and gold plans allow consumers to pay higher premiums, but lower their cost for any medical services they receive; bronze and silver plans allow Californians to pay lower premiums, but pay higher costs each time they need medical care. Additionally, there will be a “catastrophic” plan available for Californians younger than 30 years, or for those who can certify hardship that prevents them from purchasing coverage.
Paying for Health Insurance
Three programs will begin helping Californians afford health insurance after January 2014. Eligible families can receive tax credits they can use to insurance premiums. Cost-sharing subsidies reduce out-of-pocket expenses for health care services. The State of California intends to expand the Medi-Cal program, which is the Medicaid program in California, to cover people under age 65, including people with disabilities, with income of less than $15,856 for a single individual, and $32,499 for a family of four. This coverage is free for those who qualify.