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ObamaCare in California

 

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About Obamacare in California

Most people are now required to have health insurance coverage as part of the Affordable Care Act (Obamacare). Only people who apply for an exemption will not be required to obtain insurance. Nevertheless, those who are not exempt and decide not to sign up will be charged a penalty of either $95 per adult or one percent of the family income. If you want to know how to be exempt, visit: https://www.healthcare.gov/exemptions/.  Also, if you have Medicare, Medicaid, COBRA or any other insurance, you do not have to sign up for Obamacare in CA.

 

For those who want to get coverage, California has its own official Marketplace called “Covered California” which you can find at: https://www.coveredca.com/. In coveredCA.com you will find health insurance plans with benefits that fulfill all your needs and you will be able to find out if you are eligible for Medic-Cal. On this website, you will review and compare plans to choose the correct one for you.

 

 

Individual & Family Coverage

California residents have access to quality health services through Covered California. The open enrollment period began on October 1st, 2013 and ended on March 31st; 2014. However, if you missed it, you may be eligible for a special enrollment period if you have a qualifying life event such as getting married, having a child or losing your job-based coverage; you will have a period of 30 days after your life event to apply. The next enrollment period starts on November 15, 2014.

 

There are four types of plans called metal plans: Bronze, Silver, Gold and Platinum. The copays, deductibles and coinsurance will vary depending on the plan you choose. Those who have lower premiums tend to have higher out-of-pocket expenses and the ones who have high premiums require less copays, deductibles and coinsurance.  There are also Catastrophic plans with lower premiums but high deductibles, and copayments and that do not cover all the same benefits as the metal plans. These are for people under 30 or with hardship exemptions.

 

 

Small Businesses

Small business owners in California are not required by law to offer Obamacare coverage to their employees. Nevertheless, providing it is a great idea to be more competitive and make your business more appealing to employees. If you have a small business with less than 50 employees you will find a specially designed marketplace for you in Covered California that allows you to browse different plans and buy health insurance plans for your employees.  This section is called Small Business Health Options Program (SHOP) and you can find it at: https://www.coveredca.com/small-business/.

 

If you want to use SHOP, you must cover all your full-time employees and they must work at least 30 hours per week. The enrollment is once a month, until the 15th of every month. If you want to enroll, you must do it by paper. You will find the application at https://www.coveredca.com/small-business/apply/ and then you can mail it to the address found on the same link.

 

 

Pre-Existing Conditions

Whether or not you have a pre-existing condition or are healthy, the law requires insurance providers to cover all individuals, regardless of their health status or gender. In early 2014, Obamacare in California established that people who do not have insurance must get one that covers their essential health benefits without being denied the opportunity because of their gender or a pre-existing condition.

 

Additionally, the insurance companies will no longer be able to drop your coverage if you get sick, nor will they be able to charge higher premiums if you have a pre-existing condition. Premium costs will only be based on age, income, family size, geographical location and tobacco use. Grandfathered plans are an exemption, which don’t require you to abide by this new law.

 

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