Are you currently in a Covered California plan or in need of insurance??? Are you unsure if you qualify for Medi-Cal?

Persons wishing to schedule an appointment with a Covered California Enrollment Counselor, who can assist with Questions, Renewal or Enrollment, are encouraged to call Mountains Community Hospital’s Eligibility Specialist at (909) 336-3651 ext. 3535.

COVERED CALIFORNIA OPEN ENROLLMENT: NOV. 1, 2017– JAN. 31, 2018

RENEWAL FOR EXISTING COVERED CALIFORNIA PLANS: OCT. 15, 2017 – DEC. 15, 2017

With all of the press in the news and on social media, regarding changes to the Affordable Care Act (ACA aka Obamacare), Mountains Community Hospital would like to address some of the most common MYTHS.

MYTH

The ACA is no longer law. The requirement to enroll in health insurance is no longer necessary.

FACT

Although much is being done by the current Administration to repeal it, the ACA is still the law.  Nothing has been done, as of this date, to repeal the current law.

If the ACA is repealed, no changes would take place to current law until 2020.  This means that from 2020-2026, block grants to Medi-Cal and premium subsidies would be phased out.  Block Grants are the funds the Federal Government supplies the states to supplement expanded Medi-Cal.  A premium subsidy is the amount of dollars towards an insurance premium, which the federal government agrees to pay, to supplement an insurance premium. It is based on the insured’s income.

From 2026 forward, no future federal funding for healthcare will be provided, unless a replacement law is passed.   This date was given by the State of California and is based on the assumption that the ACA will be repealed.

MYTH

“The ACA is not really affordable anyway, so I hope it is repealed! All it does is force people to buy insurance they cannot afford.”

FACT

The ACA mandates much more than just a requirement for everyone to have insurance or face tax penalties. The ACA expanded Medi-Cal in California to include all residents, based on income. Prior to the ACA, in order to be qualified for Medi-Cal one must be under 21 or over 65 years of age, be blind or disabled or have minor children at home.  A single person, age 22-64, without any income, would not qualify for coverage under Medi-Cal prior to the ACA.

The ACA removed the pre-existing health condition exclusions. Prior to the ACA, a person with a pre-existing illness, such as diabetes, would have a difficult time finding a plan that would cover them. If they did find such a plan, most likely the premiums would be cost prohibitive.  If the person could find a plan they could afford, the plan could require that they keep coverage in effect for up to one year before it would pay anything related to the diabetes diagnosis.

MYTH

“The premiums are increasing so much this year that no one can afford them. I have a 52-year old friend who only makes $21,000 per year and her premiums went up to $550 a month!”

FACT

Yes, the health insurance premiums did increase for 2018. However, so did premium tax assistance.  A 52-year old person making $21,000 per year would be eligible for up to $459 per month tax assistance.  A HEALTHNET SILVER HMO plan costs $549 per month, minus the $459 tax assistance.  So, in this case, the cost to the insured would be only $90 per month.

FACT

People may receive unsolicited phone calls from unscrupulous insurance providers offering plans with “No Deductible” or “Out of Pocket” co-pays.

REMEMBER: IF IT SOUNDS TO GOOD TO BE TRUE, IT PROBABLY IS!

All insurance policies must meet the MEC (Minimum Essential Coverage), as mandated by the ACA, even though these solicitors will tell you the ACA is no longer in effect.

It is easy to see that there are many misconceptions regarding the ACA.