SANTA CLARA COUNTY, CALIF.— The County of Santa Clara is preparing for the Covered California health insurance open enrollment that begins October 1. Under the Affordable Care Act, all American citizens and legal residents must have health insurance by January 1, 2014. The Santa Clara Valley Health & Hospital System is expanding its Patient Access Department to help individuals determine if they qualify for financial assistance and the Santa Clara County Social Services Agency has established a call center to help local residents know their health care options.
“I am excited that open enrollment in Covered California has finally arrived. The next step is making sure that people have all of the information they need to make informed decisions,” said Santa Clara County Board of Supervisors President Ken Yeager. “Healthcare is a basic human right. The Affordable Care Act gets us closer to ensuring better health for all of us.”
Many Santa Clara County residents may not understand what reform means for them or if they do not have health insurance, will they be able to qualify for financial assistance. Residents should know the following information about the new Covered California healthcare marketplace:
WHO CAN GET COVERAGE THROUGH COVERED CALIFORNIA?
• Individuals without insurance whether employed or unemployed
• Individuals who have been denied coverage due to pre-existing conditions
• Individuals who are not already on a government program
• Individuals who are unable to obtain health insurance through their employer
WHAT DOES THE PUBLIC NEED TO DO?
· If individuals already have health insurance from an employer, they don’t have to do anything. Many health care reform changes that affect plans are already in place. If there are additional changes, they should get those details at their next open enrollment.
· If someone is already self-insured, some plans are being updated to include protections health care reform requires. The health insurance plan should identify if there will be any changes that will affect their members’ coverage.
o Self-insured individuals can also check out California’s health insurance marketplace to see if one of those plans better meets individual needs.
· If someone is uninsured, they may qualify for financial help (subsidies) or a tax credit. If they are not insured because of a pre-existing condition or illness, they can no longer be denied coverage. Go to www.coveredca.com to learn more. Please note:
o Undocumented immigrants do not qualify for Affordable Care Act benefits; and
o Currently incarcerated individuals do not qualify for Affordable Care Act benefits.
· If a resident is in the Medi-Cal Program, coverage is the same, the individual just needs to renew every year as they do now.
The Social Services Agency’s Health Care Reform Call Center opened today, October 1. The call center is open Monday-Saturday, from 8 a.m.-8 p.m., the same hours as the Covered California phone lines to enable individuals calling Covered California’s 800 number (800-300-1506) to be transferred to the County’s call center and speak directly to a person, not an automated system. Social Services staff will also assist applicants who choose to apply online at www.BenefitsCalWIN.org, apply by mail or who come into agency offices. Additionally, interested community members can call direct at 408-758-3800, Monday through Friday, 8 a.m.-5 p.m. to receive new information on health care programs and coverage options.
“We know that children and families with insurance are healthier because they have a primary care doctor, regular check-ups and preventive care,” said Supervisor Cindy Chavez, Chair of the Board’s Children, Seniors, and Families Committee. “The October 1st commencement of eligibility and enrollment activities is the beginning of the kind of reform we have needed for a long time. The results will be significant for individuals, local communities and our state as we realize the economic, social and productivity gains the Affordable Care Act will deliver in the years to come.”
Covered California offers five levels of coverage – bronze, silver, gold, and platinum and minimum coverage– with a range of premium and co-pay costs. Some options are more affordable than others (see chart). Plans that must cover essential health benefits – like doctor visits, maternity care, preventive care, newborn and pediatric care for your kids, prescriptions, laboratory services, behavioral health services, and more. Depending on a person’s income and family size, they may qualify for financial help to pay. The County can help identify health care options or determine if they qualify for financial assistance.
“Social Services staff has been working diligently with our partners for months to ensure that members of the public are able to access these critical new benefits, and are ready to respond to inquiries about eligibility for this system,” said Bruce Wagstaff, Santa Clara County Social Services Agency Director. “As a result of our efforts, we expect to be very busy as we implement this historic legislation.”
Patients of Santa Clara Valley Medical Center and clinics can call the Santa Clara Valley Health & Hospital System Patient Access Department at 1-866-967-4677 to get more information about the plans offered by Covered California and to find out how to apply.
“There is still a lot of confusion among members of the public about how Healthcare Reform will affect them,” said County Executive Jeffrey V. Smith. “We want to let people know we can provide clarity on this issue.”
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