Covered California Q&A
We answer the most popular patient questions about the exchange.
When will I be able to get coverage through Covered California?
Covered California began enrollment on Oct. 1, 2013, for coverage that will take effect Jan. 1, 2014. The open-enrollment period for coverage during 2014 runs from Oct. 1, 2013, to March 31, 2014. If you are eligible for Medi-Cal, the open enrollment period does not matter. This open-enrollment period is the period of time that many Californians can get federal premium assistance to reduce their costs. This premium assistance is only available through Covered California.
If you have a life-changing event, such as the loss of a job, a marriage or divorce, or the birth of a child, then you qualify for "special enrollment" throughout the year, both in Covered California and in the individual market outside. In the case of a life-changing event, you would be eligible to enroll within 60 days of that event. The next open-enrollment period begins in October 2014 for coverage in 2015.
What does Covered California health insurance cover?
All health insurance plans offered through Covered California's individual and small-group markets cover a comprehensive set of benefits known as "essential health benefits." They include the following 10 categories:
- ambulatory patient services
- emergency services
- hospitalization
- maternity and newborn care
- mental health and 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 oral and vision care
Will I be able to purchase a dental plan and a vision plan through Covered California?
Dental and vision benefits will be available for children. Covered California is considering adding vision and dental plans as "supplemental plans" for adults through Covered California in 2014. The timing of adding these benefits has not been determined. As a supplemental benefit, the federal premium assistance would not apply to these benefits.
How can you use Covered California in conjunction with Medicare parts A, B and D?
Individuals who are eligible for Medicare will not be eligible to receive premium assistance through Covered California. Additionally, Medicare supplement insurance (Medigap) plans will not be offered through Covered California.
If you need assistance with your online application or general information searching for a Caduceus physician, email us at mobile@caduceusmedicalgroup.com or stop by our Chat Room at the Life Center.
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