Medi-CAL

MEDI-CAL: COVERING MORE CALIFORNIANS
Fact Sheet Expanded Coverage Medi-Cal, as a health insurance program, has been covering Californians who couldn’t afford health care since 1966. Currently there are 8.5 million people enrolled. Under the Affordable Care Act (ACA), Medi-Cal coverage will expand in 2014, making one million to two million new people eligible. In recent surveys, most current individuals enrolled in Medi-Cal report having a positive experience with the program and agree that Medi-Cal provides access to high-quality care. Beginning January 1, 2014, single adults without children, ages 19-64 will be eligible for Medi-Cal. Open enrollment for Medi-Cal coverage for these individuals begins on October 1, 2013. If they are found to be eligible, their coverage begins on January 1, 2014. For all Medi-Cal applicants, there are new, simplified procedures for Medi-Cal eligibility that will also begin January 1, 2014. Eligibility is based upon income, as required by the ACA. To verify income and other eligibility data, we will rely on faster, more convenient electronic methods whenever possible. Medi-Cal will still accept applications and enroll individuals who qualify using today’s eligibility procedures. Periodic redetermination of eligibility for those who are enrolled will also be much simpler and will be done electronically whenever possible. What Services Will Medi-Cal Provide for Me? Medi-Cal covers a core set of services, including doctor visits, hospital care, and pregnancy-related services, as well as nursing home care for individuals age 21 or older through either a fee-for-service or managed care delivery system. For a majority of enrollees, Medi-Cal provides covered services through managed health plans in all 58 counties (http://www.dhcs.ca.gov/individuals/Pages/MMCDHealthPlanDir.aspx). The ACA ensures all Medi-Cal health plans offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental Health and Substance Use Disorder Services including Behavioral Health Treatment Prescription Drugs Rehabilitative and Habilitative Services and devices Laboratory services Preventive and wellness services & chronic disease management Pediatric services (including oral and vision care) Starting in 2014, the array of mental health and substance use disorder services will expand to better meet the needs of individuals eligible for Medi-Cal. The following mental health benefits will be available through Medi-Cal managed care plans or the fee-for-service delivery system: • Individual and group mental health evaluation and treatment (psychotherapy) • Psychological testing when clinically indicated to evaluate a mental health condition • Outpatient services for the purposes of monitoring drug therapy • Outpatient laboratory, drugs, supplies and supplements • Psychiatric consultation • Specialty mental health services currently provided by County Mental Health Plans will continue to be available. The following substance use disorder services benefits will also be made available to eligible Medi-Cal beneficiaries: • Voluntary Inpatient Detoxification • Intensive Outpatient Treatment Services • Residential Treatment Services • Outpatient Drug Free Services • Narcotic Treatment Services Dental care, vision services and speech therapy are generally available only to children and youths under age 21, but certain adults and pregnant women are also eligible for these services. Dental services will be available to all adults starting May, 2014. For more information on dental services through Medi-Cal fee-for-service, please visit the Denti-Cal website at: For more information on dental services in Sacramento or Los Angeles County through dental managed care plans, please visit the Denti-Cal website at: Many of these services are covered by Medi-Cal today or will be added in 2014 and will be available for both current and new enrollees. Do I Qualify for Medi-Cal? The Medi-Cal expansion starting on January 1, 2014 will open the door for a few million more low income Californians under age 65 who are currently ineligible for coverage. To be eligible, your annual income must be lower than 138 percent of the federal poverty level (in 2013 that would mean an individual who earned less than $15,856). The Medi-Cal expansion also allows coverage for parents who would lose coverage under current rules if their income slightly exceeds the federal poverty level. For more information about Medi-Cal, please log on to the DHCS website at: http://www.dhcs.ca.gov. Enrollment Covered California is the new marketplace for affordable, low cost and no cost health insurance, including Medi-Cal. It’s a “no wrong door” approach that will help Californians learn their eligibility for subsidized health benefits, compare insurance plan options, and enroll to receive coverage. The online portal will launch on October 1, 2013, allowing individuals to pre-enroll in the Covered California health plans and Medi-Cal prior to January 1, 2014. It’s important to note that California will also maintain existing pathways in which individuals enroll. All counties will still process applications at local county social services departments as well as accept applications by mail. In addition, locally based enrollment assistors will be available to help. For more infor
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MEDI-CAL: COVERING MORE CALIFORNIANS
Fact Sheet Expanded Coverage Medi-Cal, as a health insurance program, has been covering Californians who couldn’t afford health care since 1966. Currently there are 8.5 million people enrolled. Under the Affordable Care Act (ACA), Medi-Cal coverage will expand in 2014, making one million to two million new people eligible. In recent surveys, most current individuals enrolled in Medi-Cal report having a positive experience with the program and agree that Medi-Cal provides access to high-quality care. Beginning January 1, 2014, single adults without children, ages 19-64 will be eligible for Medi-Cal. Open enrollment for Medi-Cal coverage for these individuals begins on October 1, 2013. If they are found to be eligible, their coverage begins on January 1, 2014. For all Medi-Cal applicants, there are new, simplified procedures for Medi-Cal eligibility that will also begin January 1, 2014. Eligibility is based upon income, as required by the ACA. To verify income and other eligibility data, we will rely on faster, more convenient electronic methods whenever possible. Medi-Cal will still accept applications and enroll individuals who qualify using today’s eligibility procedures. Periodic redetermination of eligibility for those who are enrolled will also be much simpler and will be done electronically whenever possible. What Services Will Medi-Cal Provide for Me? Medi-Cal covers a core set of services, including doctor visits, hospital care, and pregnancy-related services, as well as nursing home care for individuals age 21 or older through either a fee-for-service or managed care delivery system. For a majority of enrollees, Medi-Cal provides covered services through managed health plans in all 58 counties (http://www.dhcs.ca.gov/individuals/Pages/MMCDHealthPlanDir.aspx). The ACA ensures all Medi-Cal health plans offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental Health and Substance Use Disorder Services including Behavioral Health Treatment Prescription Drugs Rehabilitative and Habilitative Services and devices Laboratory services Preventive and wellness services & chronic disease management Pediatric services (including oral and vision care) Starting in 2014, the array of mental health and substance use disorder services will expand to better meet the needs of individuals eligible for Medi-Cal. The following mental health benefits will be available through Medi-Cal managed care plans or the fee-for-service delivery system: • Individual and group mental health evaluation and treatment (psychotherapy) • Psychological testing when clinically indicated to evaluate a mental health condition • Outpatient services for the purposes of monitoring drug therapy • Outpatient laboratory, drugs, supplies and supplements • Psychiatric consultation • Specialty mental health services currently provided by County Mental Health Plans will continue to be available. The following substance use disorder services benefits will also be made available to eligible Medi-Cal beneficiaries: • Voluntary Inpatient Detoxification • Intensive Outpatient Treatment Services • Residential Treatment Services • Outpatient Drug Free Services • Narcotic Treatment Services Dental care, vision services and speech therapy are generally available only to children and youths under age 21, but certain adults and pregnant women are also eligible for these services. Dental services will be available to all adults starting May, 2014. For more information on dental services through Medi-Cal fee-for-service, please visit the Denti-Cal website at: For more information on dental services in Sacramento or Los Angeles County through dental managed care plans, please visit the Denti-Cal website at: Many of these services are covered by Medi-Cal today or will be added in 2014 and will be available for both current and new enrollees. Do I Qualify for Medi-Cal? The Medi-Cal expansion starting on January 1, 2014 will open the door for a few million more low income Californians under age 65 who are currently ineligible for coverage. To be eligible, your annual income must be lower than 138 percent of the federal poverty level (in 2013 that would mean an individual who earned less than $15,856). The Medi-Cal expansion also allows coverage for parents who would lose coverage under current rules if their income slightly exceeds the federal poverty level. For more information about Medi-Cal, please log on to the DHCS website at: http://www.dhcs.ca.gov. Enrollment Covered California is the new marketplace for affordable, low cost and no cost health insurance, including Medi-Cal. It’s a “no wrong door” approach that will help Californians learn their eligibility for subsidized health benefits, compare insurance plan options, and enroll to receive coverage. The online portal will launch on October 1, 2013, allowing individuals to pre-enroll in the Covered California health plans and Medi-Cal prior to January 1, 2014. It’s important to note that California will also maintain existing pathways in which individuals enroll. All counties will still process applications at local county social services departments as well as accept applications by mail. In addition, locally based enrollment assistors will be available to help. For more information, please visit: www.coveredca.com or
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Nuestros expertos en Planes de Salud Covered California o Seguros PRIVADOS, están "Licenciados y Certificados" y a tu disposición para informarte o asesorarte sobre los diferentes Seguros Medicos de Salud de Covered California.
A diferencia de otras Agencias de Seguros Medicos que representan a las compañías Aseguradoras en "exclusiva", nuestro enfoque es diferente, ya que nosotros de representamos a TI!
Para una consulta con un Agente de Seguros Medico Certificado, llena el formulario mencionado arriba y LLAMANOS YA al (562)353-5375.
Medicare es un tipo de Seguro Médico disponible para personas jubiladas que cumplan 65 años o más.
Básicamente, está compuesto por 3 partes, Parte A, Parte B y Parte D, y a partir de su elegibilidad, especialmente si tiene alguna ENFERMEDAD, es el mejor momento para solicitarla.
En general, 3 meses antes o después de cumplir 65 o antes, si usted es una persona con alguna discapacidad, se le permitirá unirse al plan, sin tener que preocuparse por ser declinado (a) o Rechazado (a).
Las Partes A, B y D son conocidas como Medicare Original. La Parte A, se la dan automáticamente y no tiene ningún costo. Por la Parte B, al inscribirse se deducirá de su plan de retiro un costo. La Parte D cubre sus medicamentos y usted debe comprar esta cobertura.
Medicare Original solo le cubre el 80%.
Hay opciones de diferentes planes para cubrir parte el 20% que NO cubre su Seguro Médico de Medicare y esta opción es un Seguro Médico "Medicare Advantage" conocido como Parte C o un Plan de Seguro Medico Suplemental conocido como un "MEDIGAP".
Nuestros Agentes de Medicare con "licencia y certificación" en todos los planes de Medicare, le mostraran sus "Opciones de Medicare" y dependiendo del plan, usted podrá eliminar co-pagos y deducibles médicos de doctores, especialistas, examenes, etc.
¡Los deducibles hospitalarios serán una cosa del pasado!
Covered California en Español
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Permita que nuestros Agentes Expertos en Planes de Seguro Medicos de Medicare lo ayuden a seleccionar el mejor plan para todas sus necesidades de atención médica.
Nuestra Agencia Profesional con expertos con Especialidad en Seguros Medicos de Medicare y Planes de Ahorro, se enorgullece y pone a su disposición a Agentes de habla hispana, que le atenderán en Español!
No se arriesgue en tener Costos Medicos improvisados!
Venga por su Consulta Gratis y agentes con especialidad en Medicare y conocimiento lo asistirán con esta importante decisión.
Al no tener las coberturas adecuadas, puede poner sus ahorros en peligro. Para una Cita llene el formulario o LLAMENOS YA al (562)353-5375.