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If you need health insurance, now’s the time to sign up for Covered California

, by Felipe Flores

Covered-CaliforniaCovered California is California’s health insurance marketplace created by the Affordable Care Act (ACA). People who need health insurance for 2018 can sign up for coverage between November 1, 2017 and January 31, 2018. To begin your health insurance coverage by January 1, 2018, sign up before December 15, 2017.

Although there have been attempts in Congress to dismantle and repeal portions of the ACA this year, and the White House announced that the government would no longer provide federal funding for cost-sharing reductions, Californians are still able to choose coverage from 11 health insurance carriers and take advantage of financial assistance for premiums through the program.

“Covered California worked hard to come up with a plan that ensures a stable market and protects as many consumers as possible from an unnecessary price hike,” said Peter V. Lee, executive director of Covered California.

Below, find info about what’s new this year, and where you can get additional info or help picking a plan.

Consumers are protected despite no federal funding for cost-sharing reductions

Costs-sharing reductions help lower-income consumers by reducing the cost of copays, deductibles and other out-of-pocket health care costs. On October 12, 2017, the White House announced that the federal government would no longer provide federal funding for cost-sharing reductions.

This change will not impact the availability of tax credits that consumers receive to pay their premiums. Eligible consumers will still continue to receive tax credits.

Covered California planned ahead to protect consumers from changes at the federal level and possible elimination of cost-sharing reduction funding. Consumers who are eligible for cost-sharing reductions will continue to receive them.

To make up for the change in funding, Covered California will add a “surcharge” to Silver plan rates in 2018, although Covered California leaders say most consumers will be protected from the added surcharge.

Anthem Blue Cross and HealthNet pull out of the exchange

All 11 health insurance companies have returned to the California market this year, although Anthem Blue Cross and HealthNet have left many counties in California.

If you had Anthem Blue Cross or HealthNet insurance last year, you may need to pick a new insurer and a new plan. You should have received letters in the mail from your health plan and from Covered California explaining the change and how to pick a new plan. You have 30 days from the date on your Covered California renewal notice to select a new plan and insurance provider. If you don’t actively select a new insurer and plan, you will be automatically enrolled into the cheapest plan in your tier.

If you need to select a new insurer or plan, online resources and additional help are available at coveredca.com and by calling 800-300-1506. You want to make sure that you’ll still be able to access and afford the medications and care you receive with your new plan.

Here’s an example: If you access PrEP at Strut (the San Francisco AIDS Foundation health center in the Castro) and you need to switch from Anthem Blue Cross insurance to another company, you have many options that are accepted at Strut (like Chinese Community Health Plan (CCHP)), but not Kaiser Permanente. (Kaiser Permanente requires PrEP users to use their in-network program.) Having to switch PrEP providers can be chaotic, so it’s good to be able to plan and anticipate the changes that may come when you switch insurers.

Will my doctor take my new insurance?

New to Covered California this year is a search tool that can help you find a health insurance plan that covers a specific health provider. If you already have a doctor or other health care provider that you like, you can use this search tool to make sure the insurance plan you select will be accepted by your providers.

Go to www.coveredca.com to access to access the Shop and Compare search tool.

Where can I get help?

San Francisco AIDS Foundation will hold an informational session to help people find out more about picking a plan through Covered California.

On Saturday, December 2, join San Francisco AIDS Foundation benefits navigators for an info session with LYRIC from 1 pm – 3 pm at Strut (470 Castro Street, in San Francisco).

The same benefits navigators are available to answer questions about PrEP or HIV medications during special Open Enrollment Drop-In Hours held every Thursday between November 9 and January 25 from 4 pm – 6pm (excluding holidays November 23 and December 28) at Strut (470 Castro Street, San Francisco). You can also call the PrEP team with questions at 415-437-3450.

To get help with the application process or to get answers about health, you can call the Covered California Service Center at 800-300-1506 or (TTY): 888-889-4500. You can also find help at www.coveredca.com/get-help/.

You can find a list of frequently asked questions about Covered California for people living with HIV and hepatitis C, and people considering PrEP from the California HIV/AIDS Policy Research Centers.

Felipe Flores is the manager of PrEP benefits and navigation for San Francisco AIDS Foundation.

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