The number of Americans who want the appropriate Health coverage and costs connected with health care in the U.S have only grown exponentially. This is a disturbing phenomenon on the affordability of the health-care system and nevertheless, This had been a plan for Barack Obama, When He ran for the president in 2008. To reform health care to make it affordable and to have basic health insurance coverage for the citizens had the foremost action points for the president.
As critical was this priority, The president threw the above within 14 months of his presidency stature. The enactment of the Patient Protection and Affordable Care Act, or known as ACA or better referred to as Obama care, focused on reducing costs and widening the coverage. This made significant differences in the health insurance industry and in America’s overall health care. The key accomplishment of the ACA had been that it brought about the establishment of online health insurance marketplaces in several states in the U.S. In the state of California, it is Covered California.
We will delve in detail about the Covered California marketplace and the advantage that the residents of Los Angeles will get from it for their health insurance.
Covered California
The health care marketplaces had termed exchanges under the ACA and if any state could not establish one, the federal government would establish one for that state and encompass it within the Federal Healthcare. These ACA exchanges will be the online storefronts for the citizens to compare and purchase coverages from the health insurance providers. The exchanges are not insurers. These ACA exchanges route the request to the related states health insurance agency for people who have low-income ranges. Eg, Routing of the application for health coverage to Medi-Cal in the state of California will be taken care of by the ACA agency in California.
Covered California is the online health coverage marketplace that is ACA-compliant and took satisfaction in being the first state marketplace established. Just after six months from the enactment of the ACA, Governor Schwarzenegger and the California Legislature passed the law to set up Protected California which originally started as California Health Benefit Exchange.
Saving Money on Health Insurance – Covered California
There are three independent reforms of the ACA that was accomplished by the law passed with the goal of minimizing health care costs and maximizing the coverage via the health insurance.
Let’s review those three reforms here:
- Pre-existing conditions coverage – Prior to the ACA, the insurance companies could deny health care coverage for pre-existing medical conditions. This forced the people who could not buy the insurance as they paid directly for their healthcare
- Individual’s mandatory coverage – The ACA mandates that every individual in the U.S. be covered through individual health insurance or through the employer or under a government program. Those who fail this should pay a penalty to the IRS at the end of the year.
- Health Insurance Exchanges Subsidy – In order that many people buy health insurance through these exchanges, subsidies had assured to families who earned four times the federal poverty level. With these subsidies, The original cost of obtaining health insurance had reduced.
Of these reforms, Penalty to the IRS had reduced to $0 through the Tax Cuts and Jobs Act in 2019. But through Covered California, You can still enjoy the subsidy and also get coverage if there is a pre-existing medical condition.
The Metal Tiers System of Covered California
The different plans in Covered California was termed as different metal tiers and it made the comparison easier for the consumers. The four different tiers of the ACA, viz. bronze, silver, gold, and platinum classifies the plans depending on the percentage of the health care costs of the insured that will be paid by the insurer.
Bronze – 60% of the covered medical bills will be paid by the insurance company. The other 40% will be borne by the consumer through co-pays or through deductibles.
Silver – 70% of the medical costs are covered by the insurer and the remaining 30% has to be paid by the insured.
Gold – 80% of the healthcare costs are required to be paid by the insurance company leaving 20% to be paid by the individual.
Platinum– 90% of the medical costs are taken care of by the insurance company and the specific needs to arrange the remaining 10%
It is very important to note that the premium for a higher-tier plan is usually costly compared to a medium-low tier. But, The ACA assures subsidies which are required to reduce the financial strain with high premium amounts
Medi-Cal for Low-Income citizens
It can be a surprise to know that even low-income individuals qualify for an insurance policy through Covered California. Though the ACA limits the subsidies for a specific income range of its citizens, the folks who earn lesser than that threshold can now avail free or reduced health insurance coverage through Medical, Medicaid Implementation in the state of California.
As referred earlier, The application for MediCal coverage is well integrated into Covered California. This makes the application for Medi-Cal coverage quite simple and similar to how private insurances are sought through Covered California. The Medi-Cal can also be availed via mail or in person.
The necessity of health insurance
In the U.S. health insurance is more of a mandate than just a necessity. The amount of money that one tends to spend on health care has at times landed individuals in situations of bankruptcy. Recovery Law Group has seen many individuals who have reached this condition because of their inability to take care of the medical bills or have surplus debts because of inappropriate planning for health care. In Los Angeles, California and in Dallas, Texas, consult with a bank attorney from the Recovery Law Group to understand the importance of health insurance. Explore Covered California and purchase the tier plan that is best suited for your income range and for your family needs.
