questions1Frequently Asked Questions

Before you call a counselor, check out our frequently asked questions to see if your question is answered here:

009 When is the deadline to buy health insurance?
 009 Is everyone required to have health insurance?
 009 What are tax credits (AKA premium assistance)?
 009 Am I eligible for tax credits?
 009 How does health reform affect women?
 009 What happens if I don’t get health insurance?
 009 Can undocumented or unlawfully present parents apply for coverage for lawfully present children or dependents?
 009 What if I already have health insurance?
 009 Will Covered California information be shared with federal agencies (i.e. Homeland Security) as a resource to locate undocumented workers

Q: When is the deadline to buy health insurance?

 

A: As of January 1, 2014 most Californians must have health insurance or they will be subject to a penalty for not having coverage.

To buy health insurance through Covered California you must either have a qualifying event or wait until open enrollment.

Covered CA  next open enrollment:  

November 15, 2014- February 15, 2015

* You may still be eligible to apply for coverage outside of open enrollment if you have had a qualifying event. Please contact 323 295 9372 for further information.

 

Medical Enrollment:

Individuals and families may apply for the Medi-Cal program at any time.

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Q: Is everyone required to have health insurance?

 

A: Yes, unless you are, very low income*, unable due to religious beliefs, Native Americans, Incarcerated, or undocumented

*Your family income must be below the threshold for filing a tax return.In 2013, this threshold was $10,000 for an individual and $20,000 for a family.

There may be other factors that impact your requirement for health insurance. Call us at (323) 295-5500 if you would like to discuss further.

Q: What are tax credits (AKA premium assistance)?

 

A: To help bring down the costs of monthly premiums and other out-of-pocket expenses, some individuals or families may receive financial assistance through Covered California in the form of tax credits.

Tax credits vary depending on your income level.

Use Covered California's Shop and Compare Tool to see if you qualify for premium assistance.

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Q: Am I eligible for tax credits?

 

A: Eligibility for subsidies is based on  income level and family size. Families or Individuals who make between 138% - 400% of the Federal Poverty Level may qualify for subsidies.

You can use the Covered California's Shop and Compare Tool to figure out if you're eligible for tax credits and what your premiums could be.

Consumers being offered employer based insurance may not be eligible for subsidies through the exchange. Please contact 323 295 9372 for further assistance.

Q: How does health reform affect women?

 

A: Women can't be denied coverage because of gender-related concerns.

Below are some new advantages:

       Maternity care is required
       You can not be charged more for being a woman
       You do not need a referral to see an OB-GYN
       You can choose your child's pediatrician
 

All of following preventative services are free and guaranteed:


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Well-woman visits.
050
Gestational diabetes screening.
041
Domestic and interpersonal violence screening and counseling.
037
FDA-approved contraceptive methods, and contraceptive education and counseling.
044
Breastfeeding support, supplies, and counseling.
039
HPV DNA testing, for women 30 or older.
040
Sexually transmitted infections counseling.
021
HIV screening and counseling.
002
Mammograms and colonoscopies.

 

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Q: What happens if I don't get health insurance?

 

A: You may be subject to a tax penalty that grows more expensive year by year.

In 2014, the penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1% of the family income, whichever is greater.

In 2015, the penalty is $325 per adult and $162.50 per child (up to $975 for a family) or 2% of the family income, whichever is greater.

In 2016 and beyond, the penalty is $695 per adult and $347.50 per child (up to $2085 for a family) or 2.5% of the family income, whichever is greater.

Q: Can undocumented or unlawfully present parents apply for coverage for lawfully present children or dependents?

 

A: Undocumented or Unlawfully present parents can apply for coverage for lawfully present children or dependents as long as you have a Tax Identification Number, commonly known as a TIN or attest that you will use a Tax ID number to file taxes in the future. This will allow dependents or children to receive eligibility determination.

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Q: What if I already have health insurance?

 

A: If you already have one of the following, you are already meeting the legal requirement to have health coverage and you would not be subject to the penalty.

 1.  An eligible employer-sponsored plan (that meets the minimum essential coverage guidelines) 

2. An individual policy (that meets the minimum essential coverage guidelines)

3. A government plan (Medicare, Medi-Cal without a Share of Cost (SOC), TRICARE, VA, etc.)

Q: Will Covered California information be shared with federal agencies (i.e. Homeland Security) as a resource to locate undocumented workers?

 

A: No. The ACA and federal law prohibits any information gathered for the purposes of insurance affordability programs to be used for any other use.

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For more, visit the Kaiser Family Foundation's Frequently Asked Questions page on health reform.