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Obamacare is Here: California Health Care FAQS

When it comes to the local rollout of the Affordable Care Act, we’ve got you covered

I’m interested in signing up for Obamacare. Where do I begin?
Under the Affordable Care Act, each state has set up health care marketplaces where individuals and families can shop for or simply compare health coverage options. California’s marketplace is called Covered California, and all legal residents of the state can buy health insurance there.

When and where can I sign up?
Open enrollment for 2013 coverage has begun and will continue through March 31 of next year. (If you’re also eligible for Medi-Cal, California’s program for those who earn $15,856 or less, this open enrollment schedule does not apply to you.) You can shop for insurance online, over the phone by calling 800-300-1506, or in person.

But I heard the online system isn’t really working. Should I wait until the bugs are sorted out?
Not yet. A customer service representative we spoke with this morning confirmed that despite maintenance that was scheduled to take place over the weekend, some customers are still experiencing issues online (others are not). They suggest you call (800) 300-1506 to speak with a representative if you run into trouble.

So what kind of coverage, exactly, is for sale?
Covered California offers four levels of coverage: Bronze, Silver, Gold, and Platinum (the greater the value of the metal, the greater coverage that level of insurance provides). Generally, Platinum plans will cover 90% of health care costs, Gold plans will cover 80% of health care costs, Silver plans will cover 70% of health care costs, and Bronze plans will cover 60% of health care costs. Premiums for each of the plans range in price according to family size and income. You can input your own variables into a Shop and Compare Tool at Covered California to get a better idea of what your costs might be. The tool will ask you the number of individuals looking for coverage, the age of each individual needing to be insured, and total household income before spitting out deductible costs for each tier of coverage.

Are dental and vision plans offered?
Not yet for adults, but Covered California does currently offer dental and vision benefits for children.

If I do purchase insurance through Covered California, can I keep my current doctors?
Like all health insurance plans, Covered California’s plans have a list of “in-network providers.” You can see if your medical provider is on the list by checking online or asking your doctor directly.

What about pre-existing conditions: can my coverage be dropped or denied if I already have a medical problem?
Nope. Your right to coverage is protected under the law—and you can’t be charged more for it, either.

Is that the whole deal?
Actually, no. Many Californians will be eligible for financial assistance to help pay for their coverage. The amount of assistance you could receive depends on household income and how many eligible individuals are in your family. For specific details on aid, check out Covered California’s Getting Financial Help fact sheet.

My health insurance is provided by my employer. Do I still need to sign up for Obamacare?
Nope. If you’re happy with the health insurance you have, there’s no need to change a thing or purchase additional coverage. However, Covered California may provide a more affordable option than your employer, so it’s not a bad idea to have a look at the systems various plans.

I’m covered now, but what if something happens to change my insurance needs after the open enrollment date?
In the case of a life-changing event, you’ll have 60 days to enroll for health insurance through Covered California.

Thanks for the info, but I’ve decided health insurance isn’t for me.
In that case, let us note that if you chose to go without coverage for 2014, you will very likely face a federal fine (some individuals may be exempt). For an individual, the penalty will cost whichever is greater: $95 or 1% of income. For families, the penalty will cost whichever is greater: $95 per uninsured adult and $47.50 per uninsured child (up to $285 per family) or 1% of the family’s income.