Tehachapi's Online Community News & Entertainment Guide

Covered California open enrollment is here!

The Open Enrollment Period for 2016 Covered California health insurance plans is here. It starts Sunday, Nov. 1, 2015 and ends Sunday, Jan. 31, 2016. All plans are Obama Care or Affordable Care Act compliant.

Covered California was created to help you get health coverage to protect yourself and your loved ones. Having insurance can ensure your access to medical care if you get sick or are injured, so that you can keep your body healthy, but it also protects your peace of mind, because you can rest assured that you will have help when you need it most.

By law, your coverage can’t be dropped or denied if you have a pre-existing medical condition or if you get sick. You may even be able to get financial assistance through Covered California to make your health coverage more affordable. This assistance is called a subsidy and comes from the Federal Government according to your income reported on your Federal Tax form.

Covered California also offers a special enrollment option for those who experience a life-changing event (such as getting married, having a child or moving) and need to enroll outside of Open Enrollment. Medi-Cal enrollment, for those with qualifying incomes, is available year-round.

If you feel you qualify for a subsidy, the plan can only be created and applied for on the Covered California site by you or your agent. I am a Certified Covered California agent and it would be my pleasure to help you choose the best plan for your needs. I represent several carriers.

Even those who are healthy today benefit from having health insurance. It’s impossible to predict whether you’ll get sick or have an accident. With the average cost of a three-day hospital stay priced at $30,000, it doesn’t make sense to take the gamble of going without health insurance, particularly if you find it at an affordable price.

A question was raised on the Jimmy Fallon show recently; “which would you rather have Affordable Care Act Insurance or Obama Care?” Most answered “Affordable Care Act Insurance because it is more affordable.” Affordable Care Act Insurance and Obama care are one in the same, just another example of misinformation and confusion by so many Americans. All health insurance today is Obama Care insurance due to it all having to be compliant.

There are four basic levels of coverage: Platinum, Gold, Silver and Bronze. As the coverage increases, so does the monthly premium payment, but the cost when a person receives medical care is usually lower. Or clients may pay a lower monthly premium, which means that when they need medical care, they will pay more. For example, if a client chooses the Platinum plan they will pay a higher premium but the cost of their care will be less.

All new health insurance plans must cover preventative care and medical screenings, like mammograms and colonoscopies as well as women’s services such as breast-feeding support, contraception and domestic violence screening. There is no charge such as copayments, coinsurance or deductibles for these services.

These plans must cover 10 Essential Health Benefits such as ambulatory patient care, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorder treatment, prescription drugs, rehabilitation and habilitation services and devices, lab services, preventative and wellness services and chronic disease support, and children’s services, including dental and vision care.

Starting in January 2014, most adults were required to have public –such as Medi-Cal or Medicare- or private health insurance or pay a fine. The fine became more costly over a three-year period. By 2016, the fine will be $695 for an individual, or 2.5 % of income, whichever is greater. For a family, it will be $2085 per family, or 2.5 % of income, whichever is greater.

I look forward to helping you make the best decision for you personally or for your whole family. I am happy to answer all questions and take the time necessary to help you be comfortable with your final decision. Our Farmer’s agency is known for its superior customer service.

I will serve you with compassion and integrity for your peace of mind.

Feel free to contact me, Sue Wonacott, cell (661-304-4695), office 661-822-3737 or by email [email protected].