Obamacare Options for South LA

What Health Insurance Coverage Now Looks Like after 2014

Obamacare makes health care coverage accessible for more people by basing health insurance rates on income, age, and region. Income helps determine which of several options are available to individuals and families. The following tables break down income and eligibility for different plans.

Table 1: Income and Eligibility for Individuals

Individuals* making … May qualify for… Type of Coverage
Less than $15,856 Medi-Cal Medi-Cal is free medical insurance from the state of California for low-income children, pregnant women, seniors, and people with disabilities. Adults between the ages of 19 and 64, with or without children, also may be eligible.
$15,856 – $28,725 A subsidy that reduces the cost of your monthly premium and assistance with the out-of-pocket cost of services (such as deductibles and co-pays) Covered California. Open enrollment into Covered California usually begins November 1st through January of the following year.
$28,725 – $45,960 A subsidy that reduces the cost of your monthly premium Covered California. Open enrollment into Covered California usually begins November 1st through January of the following year.
More than $45,960 No assistance, but you may still purchase through the health care exchange Covered California or Private Insurance. Open enrollment into Covered California usually begins November 1st through January of the following year.


Table 2: Income and Eligibility for Families

A family of 4 making … May qualify for … Type of Coverage
Less than $32,499 Medi-Cal Medi-Cal is free medical insurance from the state of California for low-income children, pregnant women, seniors, and people with disabilities. Adults between the ages of 19 and 64, with or without children, also may be eligible.
$32,499 – $58,875 A subsidy that reduces the cost of your monthly premium and assistance with the out-of-pocket cost of services (such as deductibles and co-pays) Covered California. Open enrollment into Covered California usually begins November 1st through January of the following year.
$58,875 – $94,200 A subsidy that reduces the cost of your monthly premium Covered California. Open enrollment into Covered California usually begins November 1st through January of the following year.
More than $92,400 No assistance, but you may still purchase through the health care exchange Covered California or Private Insurance. Open enrollment into Covered California usually begins November 1st through January of the following year.

*Individuals include small business owners with no employees. Adjusted gross income is used to figure eligibility for individuals who own a small business without employees.

My Health LA

To qualify for Obamacare through Covered California, patients must be U.S. citizens or permanent residents for at least five years. What happens to patients who are ineligible for Obamacare or Medi-Cal?

Southside Coalition of Community Health Centers and other Los Angeles community clinics continue to serve LA County residents who are not covered by other programs because of citizenship, residency, age, or other reasons. South Los Angeles residents can find a clinic near them at Find a Clinic or Find a MHLA Provider. Los Angeles County Department of Health Services is committed to continuing this program and for details on this program click here My Health LA.  You can also download our brochures in ENGLISH or  SPANISH  or view videos developed by the Southside Coalition:

 

Medi-Cal

If you already had Medi-Cal coverage in 2014, you were able to keep it. You must still renew your plan each year. Plan participants will be notified by mail with directions.  In May, 2016 the State of California expanded the Medi-Cal program for undocumented children from 0-18 years of age, known as #Health4AllKids.

Obamacare: Covered California

Patients who earn too much to qualify for Medi-Cal may be eligible for health insurance coverage through Covered California and have their premium subsidized by the federal government.

Individuals who earn too much to qualify for the subsidy may still purchase through Covered California.

To purchase through Covered California, patients must be U.S. citizens or legal permanent residents for at least five years and not covered by an employer’s plan.

Private Insurance

Individual plans may still be purchased directly through health insurance companies and agents. By law, these unsubsidized plans still must meet the minimum care requirements of the Affordable Care Act. This includes preventive doctor’s visits, well-baby and well-woman care, screenings for cancer, and more.

 

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