California Health Insurance Marketplace: Access For Low-Income Individuals
Low-income Californians can access affordable health coverage by visiting the state’s online insurance marketplace, Covered California. The site allows residents to find and compare plans for free or at discounted rates, depending on their household income. Cost barriers have prompted 55 percent of low-income Californians and their family members to delay medical treatments in the past year. Many who waited for care said they had to cut other spending or drain their savings.
California’s Medi-Cal program offers medical insurance to low-income residents. The program serves many people, including children and their families, senior citizens and people with disabilities, current and former foster care youth and pregnant women. It also offers coverage for high-cost medical conditions such as cancer, HIV/AIDS and organ transplantation. Eligibility for the program is based on income and, in some cases, property ownership. Individuals can apply at their local county social services office with help from a benefits planner or counselor or through a streamlined online application.
Individuals who meet the program’s eligibility requirements can enroll in one of several pathways to affordable health coverage, including premium assistance through the state’s regular insurance marketplace, Covered California. They can also seek medical coverage through the California Medicaid program, known as Medi-Cal. For a variety of low-income persons and families, including children and their parents, seniors, people with disabilities, current and former foster adolescents up to age 26, and pregnant women, Medi-Cal provides free or affordable health coverage. In most cases, enrollment in the program is automatic if an applicant meets certain criteria. With the aid of online websites like IEHP, you can check the eligibility requirements.
Under the Affordable Care Act, many families in California now have access to affordable insurance options. While Medi-Cal provides free or low-cost healthcare, those who no longer qualify for this program can also access financial assistance through Covered California, the state’s regular health insurance marketplace. It includes premium service, a tax credit that helps reduce monthly health insurance costs, and cost-sharing reductions, which help lower out-of-pocket medical expenses like copayments and coinsurance. Covered California’s open enrollment period runs from Nov. 1 through Jan. 31, 2023, but individuals can still apply outside of this time if they have a qualifying life event. For example, a Sacramento couple earning $83,250 a year would be eligible for premium assistance that could help them buy a Bronze plan through Covered California for $67 a month. According to a UC Berkeley Labor Center report, this new rule will help 391,000 families previously forced to spend a large percentage of their income on a family member’s employer-sponsored health insurance or go uninsured. It’s important to remember that no one should have to skip or delay healthcare due to its cost.
Many low-income families and individuals in California can access affordable health insurance options thanks to financial assistance programs. These include Medi-Cal, premium assistance and cost-sharing reductions. In addition to income requirements, homes must also meet citizenship and residency requirements. Medical inflation has outpaced consumer prices in recent decades, reducing what families and individuals can afford to spend on health care. As a result, those who do not have access to employer-sponsored health plans or other major public health insurance programs need help to afford the cost of health coverage. It is especially true for those unable to use the premium assistance program. The federal program combines state financial aid with federal health insurance tax credits to help members minimize the cost of their monthly health insurance payments. However, they will still be responsible for paying other expenses, such as deductibles and co-pays.
Green Card Holders
Green card holders have access to state Medicaid programs (which may be called something different in each state) and Medicare Parts A and B, which cover doctor visits and X-rays. They also have access to Medicare Part D, which covers prescription drugs. In addition, some states offer premium tax credits and savings for Marketplace insurance to green card holders who meet certain income and residency requirements. Unlike undocumented individuals, green card holders can use these resources to improve their health and finances. Using or receiving Medicaid, CHIP, SNAP, TANF, low-income housing, and financial assistance through the marketplace won’t make a green card holder a “public charge.” However, green card holders should know that there are limited options for affordable care outside of Medi-Cal. Green card holders can make healthcare coverage more affordable by applying for financial assistance through California’s regular marketplace, Covered California. A person or family must have an annual household income between 138 and 400 percent of the federal poverty line.
Many newly eligible workers without legal status in agriculture, hospitality and child care help drive California’s economy. Previously, income-eligible immigrants without citizenship could only receive scaled-back emergency services through Medi-Cal. The expansion will change that. The new rules will apply to adults ages 26 and older starting in 2024.
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