The Affordable Health Care Act and Covered California were the featured topics of the Sept. 26 Healthy Woman Ladies Night Out event at Fallbrook Library. The event was attended by a large crowd wanting to know more about the new options in health care coverage.
The program presenter, Karis Grounds, works for 2-1-1 San Diego, which is a resource and information center that connects people in San Diego County with community, health and disaster services through a free, phone service 24 hours a day, seven days a week.
The presenter explained that each state could decide to go with a federal insurance program/exchange or manage its own exchange. Covered California is the program California is offering its residents. Legal residents without access to health insurance – those who cannot get it through their employer or cannot afford it – are eligible for Covered California or Medi-Cal.
In this program, residents cannot be denied coverage due to pre-existing conditions and rates are not based on one’s health status, Carris said. Anyone who pays more than 9.5 percent of their income for insurance is also eligible for the program. There are three levels of coverage depending on one’s income; an income specific eligibility schedule can be found at www.coveredca.com.
There are 10 essential benefits in the program – ambulatory patient services, emergency services, hospitalization, maternity/newborn care, mental health and substance abuse, rehab/physical therapy, laboratory services, preventative care, pediatric services and prescriptions.
There are six health insurance companies in San Diego County that are available in Covered California – Anthem Blue Cross, Blue Shield, Health Net, Kaiser Permanente, Molina Healthcare and Sharp Health Plan.
Anyone needing help or more information can call 2-1-1 and a customer service representative will answer questions and go through the insurance calculator with the caller.
Open enrollment for Covered California is Oct. 1 through March 31. Applicants need to have their social security card and income information with them.
For more information, visit www.211sandiego.org or
The next Healthy Woman Ladies Night Out will be on Wednesday, Oct. 30 (instead of on Halloween).