Congress gave Americans the Affordable Care Act in 2013, enabling American consumers the possibility of obtaining affordable, effective health care by obtaining health insurance through government sponsored programs or through the Health Insurance Market Place. The three government sponsored programs are Medicare, Medi-Cal and Covered California.
Residents who are over 65 years of age as well as individuals who have received Social Security Disability benefits for at least 2 years, are eligible for Medicare. This is a federally sponsored program which is paid for by employee and employer tax contributions throughout an employee's career. There are no income restrictions for individuals to receive this benefit.
Anyone eligible can apply for Medicare:
- Online at www.SocialSecurity.gov ,
- Call Social Security at 1-800-772-1213 (TTY users 1-800-0778), Monday through Friday, from 7:00 a.m. to 7:00 p.m., or
- In-person at your local Social Security office.
Those qualified for Medicare may also be eligible for a state sponsored program, Medi-Cal which does have income restrictions. This program is mainly for low income individuals or families, or those individuals with few assets. Medi-Cal can help provide covered individuals with assistance to pay premiums, co-pays and deductibles for Medicare.
Medi-Cal consists of many programs. Some Medi-Cal programs base eligibility upon income only, while other programs are based upon the individual's or family's property. Some programs are no cost, while under others the individual or family may have to pay a share of the medical costs or pay a monthly premium. There is no enrollment period and consumers may apply 365 days of the year. Apply for Medi-Cal in the following ways:
- Online at www.c4yourself.com or www.coveredca.com ,
- Call your local Department of Social Services (in Nevada County call 530-265-1340, Monday through Friday, from 8:00 a.m. to 5:00 p.m.,
- FAX an application to your local Department of Social Services (In Nevada County send to 530-265-9860), or
- In-person at your local Department of Social Services (in Western Nevada County, located at 950 Maidu Avenue, Nevada City, CA 95959, in Eastern Nevada County located at 10075 Levon Ave, Truckee, CA 96161).
Low and middle income individuals and families may purchase health insurance from a central Market Place which, in California, is called Covered California and they may qualify for financial assistance to pay the health insurance premiums though Health Insurance Premium Tax Credits and Cost Savings Assistance. The Premium Tax Credits can be paid to the consumer when they file their Federal Income Tax Returns, or they may choose to receive the benefit of the tax credits each month by way of Advanced Premium Tax Credits, which are paid directly to the insurance companies toward their premium. In order to qualify for these tax credits, consumers must apply during an open enrollment period.
Covered California Open Enrollment
For calendar year 2019, the Open Enrollment period will run from October 15, 2018 through January 15, 2019. Under certain circumstances, consumers will also qualify for a Special Enrollment Period, which runs for 60 days from the date of the qualifying event. Consumers may claim a Special Enrollment Period if they lose other coverage (Medi-Cal, employer sponsored coverage, COBRA, student health care or coverage from a parent), move to California or get released from jail or prison, get married or have a baby.
Apply for these benefits through Covered California online at www.coveredca.com.