Despite the many successes seen under the implementation of Obamacare, recent information shows that thousands of Americans are still awaiting coverage. Under the California Health Insurance Exchange, and comparable exchanges for other states, some consumers “picked a private health plan and paid their premiums only to learn recently that they aren’t insured.” While the number of consumers experiencing coverage issues seems to be quite minimal, this still leaves major concerns for those without coverage due to enrollment problems.
Click here to read the full article by Stephanie Armour for Wall Street Journal.
Reports this week claim that the California health exchange marketplace failed to verify important personal data during the application period. This process is critical in determining whether or not people applying are eligible for subsidies, and failing to resolve discrepancies during the process may have provided healthcare to some Americans who may not be legally entitled to obtain government subsidies.
Click here to read the full article by Judy Lin for the Associated Press, featured on the Sacramento Bee.
A new study conducted by consultants at McKinsey & Company has said that many health exchange programs, including California Health Exchange programs, offer wide networks that “include at least 70 percent of the hospital in the [qualified health plan]’s area.” This study confirms that those with qualified health plans can obtain access to a broad network, and price differences are not terribly significant between plans.
Click here to read the full article by Allison Bell for LifeHealthPro.
Now that the open enrollment period for the Marketplace has ended, it is important to be aware of your rights if you need to make a change in your health insurance in California. You can enroll in Covered California private coverage only if you have a life event that qualifies you to do so, or are the victim of a complex situation related to errors within the Marketplace.
The life events that qualify you to purchase private health insurance in California through the marketplace are marriage, divorce, adding a child to your family through birth or adoption, giving a child up for adoption or foster care, becoming a citizen, moving to a new home, and leaving prison.
You can also qualify if you have lost other health coverage for one of the following reasons: coverage was through your employer and you lost your job, your policy was an individual one and it ended in 2014, your COBRA benefits expired, you become too old to be covered on your parents’ plan, or you become ineligible for Medicaid. You do not qualify if you voluntarily give up your coverage by health insurance in California.
If you are already enrolled in Covered California you can make a change to your policy if you have a change in household income or status that affects your ability to be eligible for cost-sharing reductions or premium tax credits. In addition, if you are Native American, and a member of a federally registered tribe, you can change plans or enroll once per month for every month of the year.
Individuals can apply for Medicaid and CHIP coverage at any time. There is no limited enrollment period for those programs. If you qualify, you will be enrolled. If you have one of the above qualifying life events, you can enroll or change your private health insurance. If not, you can always try to appeal the denial of a special enrollment timeframe.
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