Covered California: Our Participation in the Health Insurance Exchange
Legal residents of California who do not have health insurance from their job or from another government program are able to buy insurance through the state’s new “exchange” called Covered California. As of Jan. 1, 2014, most people are required by law to have health insurance.
All health plans purchased through Covered California must cover certain services called essential health benefits. These include doctor visits, hospital stays, emergency care, maternity care, children’s care, prescriptions, medical tests and mental health care. They also must cover preventive care services, such as mammograms and colonoscopies.
If you buy coverage through Covered California, you may qualify for federal tax credits or subsidies. Tax credits are available to people who make up to 400 percent of the federal poverty level, or $46,000 a year for an individual and $94,200 for a family of four.
The plan options vary by location and are available at four different levels: bronze, silver, gold and platinum. A bronze plan will have the lowest monthly premium, and the insurance company will pay 60 percent of the cost of services and you will pay 40 percent. In a platinum plan, the insurance company pays 90 percent of the cost of services but you will pay a much higher premium.
For more information and enrollment assistance, call 800-300-1506 for visit www.CoveredCA.com.
Sutter East Bay Medical Foundation's Participation in Covered California
Sutter East Bay Medical Foundation (SEBMF) is participating in Covered California with:
- Blue Shield: SEBMF participates in three different individual/family plans and the Blue Shield small business health options program (SHOP). Blue Shield's website has a tool you can use to get a health insurance quote providing specific information on plan benefits, premiums and health provider networks available to you. You may also call (888) 568-3560 to speak with a Blue Shield representative about selecting a Covered California health plan that allows you to receive care from SEBMF.
- Health Net:* SEBMF doctors participate in Health Net's individual and family PPO plan and Health Net's PPO plan in the SHOP.
Health Care Reform Means Lower Cost Health Insurance
In 2010, the federal government passed a law - the Patient Protection and Affordable Care Act (Affordable Care Act) - to increase the number of Americans with health insurance and decrease the cost of health care.
The law provides access to insurance for many people who have not had it - including people with pre-existing health conditions and those who cannot afford insurance.
An overview of the Affordable Care Act, and how it affects you, is detailed in this YouTube video .
*Attention Health Net Covered California members: Sutter Health physicians and Sutter hospitals will not be participating in the Health Net Covered California PureCare individual and family plan network in 2015.