With Thursday's news about which insurance plans will be available to individuals through Covered California, state residents are getting a clearer picture of the health plans and prices offered under the new health care rules in President Barack Obama's Affordable Care Act, popularly known as Obamacare.
The state's largest health insurers — including Anthem Blue Cross, Blue Shield and Kaiser Permanente — will be among 13 plans competing to sell policies to millions of Californians who are expected to purchase coverage through the state's new health exchange, officials announced Thursday.
Covered California, the state agency running the health insurance marketplace, announced the plans and prices that will be offered by private insurers when the exchange begins enrolling customers in October. Coverage begins Jan. 1, the same time virtually everyone in the country will be required to have health insurance or pay a penalty.
So what does this mean for you? We've assembled the answers to common questions. Let us know in the comments below if you have other questions, and we'll try to find the answers.
Q: Does this affect me?
A: Yes, if you are one of the estimated 5 million Californians who lacks insurance coverage through your employer, or who earns too much to qualify for Medi-Cal. If so, you are required to purchase insurance by January 1, 2014, or face a fine.
Q: How much does it cost?
A: That depends on where you live and how old you are.
You can plug in your age and income into Covered California's online calculator to get an estimate of what you’d pay for a mid-range (silver) plan. But you won’t know the true cost range until October 1st, when the exchange’s enrollment system is complete.
Q: What if I can’t afford it?
A: Depending on your income, you may qualify for help:
- An upfront federal tax credit to help reduce your premium is available to single people who earn less than $44,680 a year, up to $92,200 for a family of four.
- A cost-sharing subsidy for out-of-pocket costs, like co-pays.
This help is only available to people who purchase a plan through the Covered California exchange.
You may also qualify for free care through Medi-Cal if state lawmakers expand the program.
Q: How do I know if my doctor is in the provider network?
A: Covered California will provide a network directory on its website later this year. Your doctor would have to be in the network of one of the providers in your area.
Q: Which plans will be available where I live?
A: Not all of the plans will be available in your area. But there will be two to six insurance plan available, depending on your Zip Code. For a full list by Zip Code go to the booklet link here or consult the booklet embedded below.
Los Angeles and San Diego will offer six carriers. Almost all counties will have at least two health plans to choose from.
Q: Can I be rejected for a pre-existing condition or my state of health?
A: No. All insurers in California must provide coverage to anyone who applies.
Q: I’m a smoker. I heard under the Affordable Care Act I may have to pay more than non-smokers? Is that true?
A: No, California opted out of that provision of the Act in favor of making insurance affordable for more people. Other states may opt to charge smokers more.
Q: When can I enroll in one of the health exchange’s plans?
A: Open enrollment is from Oct. 1, 2013, to March 31, 2014.
Q: I own a small business. When will the Exchange announce which plans will be available for me?
A: Check back in June.
Q: Where can I get more information?
A: Covered California's website page on individual health plans.
The Associated Press contributed to this report