Open enrollment for 2015 begins soon! Medi-Cal enrollment continues year-round. If you experience a life-changing event like marriage, birth of a child or loss of employer-sponsored health coverage, you may sign up for coverage within 60 days of the event in a special enrollment. For a complete list of qualifying life-changing events, click here.
The Patient Protection and Affordable Care Act is the federal law that expands health coverage to most Americans and helps to reduce costs and improve the quality of our existing health care systems.
Starting January 1, 2014 most U.S. citizens will be required to have a basic level of health coverage.
Key features of the Affordable Care Act (ACA) include:
- Expanded Medi-Cal: Partnership Health Plan of California now covers adults without children with incomes up to 138% of Federal Poverty Level (FPL)
- Health Insurance Marketplace: Establishes on online exchange where individuals and families with incomes up to 400% of FPL can purchase private health insurance.
- Income tax credits, subsidies and cost-savings strategies are available to reduce premiums and out-of-pocket health costs.
Protection and Prevention
- Pre-existing Conditions: Insurance companies can no longer deny coverage to anyone with a pre-existing condition and a medical exam is no longer required to qualify for coverage.
- Lifetime Limits: Insurers are not allowed to set a maximum dollar amount they will pay for key health benefits.
- Young Adult Coverage: Dependent adults up to age 26 will be allowed to stay on their parents plan.
- Preventative Care: All new health plans must cover preventive care and certain medical screenings.
- Essential Health Benefits: New health plans must cover services that fall into the 10 categories of
Improving Quality & Lowering Costs
- Strengthens Medicare: The ACA supports existing Medicare benefits and expands preventive and prescription drug benefits.
- Business Tax Credits: Many small businesses will also be able to provide employee health insurance using federal tax credits to reduce premium costs.
- Increased Accountability for Insurance Companies: Insurers must justify any premium increase of 10% or more before the rate takes effect. Rate reviews protect individuals and businesses from unreasonable insurance rate increases.