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10:24

The Changing Face of California HealthCare

The key components to successful implementation of the California Health Exchange have been identified as providing affordable California Healthcare plans, successful outreach and education, and smooth enrollment. Town hall meetings led by California Board members and senior staff have been held throughout the state and continue to be scheduled as the expected implantation date of October 2013 continues to draw near.

As part of the federal healthcare law, the Patient Protection and Affordable Care Act, all newly sold insurance plans must meet certain requirements and insurance must cover certain essential health benefits. All new health plans must cover essential health benefits such as doctor visits, hospitalization, emergency care, maternity, pediatric care for children and prescriptions, among other services. All plans will be ranked for easy comparison and will be rated based on the percentage of medical expenses paid by the plan and how much is left to the individual. With the new California healthcare plan, there will be four basic levels of coverage:

•    Platinum
•    Gold
•    Silver
•    Bronze

This ranking system will help make it easier to compare plans in the same category or across categories. As the ratings go up, so do the monthly premium payments, but costs are lower when receiving medical care. People can choose to pay a higher monthly cost so that when medical care is needed, it will cost less. Individuals can also choose to pay a lower monthly cost so that when medical care is required, they will pay more. It can be overwhelming to find the right health plan to best meet individual needs. Before getting started, it is important to understand another big change happening in California healthcare and insurance coverage. Starting in 2014, all health insurance newly sold to individuals and small businesses must be classified into one of the four levels of coverage. In addition, a "catastrophic" plan will be available to those who are under 30 years old or those who can provide a certification that they are without affordable coverage or are experiencing undue hardship.
In a marketplace operated by Covered California, private companies will also compete for health insurance business and will be open for enrollment starting later this year for coverage that will begin in January 2014. Individuals will soon be able to buy the same health insurance that is currently sold in the private market. If a person already has health insurance that the employer has provided and is deemed as affordable, then no action is required. However, if an individual is paying more than 9.5 percent of the total household income toward health insurance premiums, they may also be eligible for financial assistance available under the new California healthcare plan.

Enrollment will open later this year and continue until March 31, 2014, and is necessary in order to obtain coverage for California healthcare in 2014 with few exceptions that include major life changes. This period affords both the time to understand what specific plan may best suited based on individual needs and provides clear information to help the greater community as a whole to curb costs of providing care to those without insurance.

This article was written by Erwin Morentin on behalf of ExchangeCoverage.com, our vision is to improve the health of all Californians by assuring their access to affordable health care . To know why American healthcare is out of control, visit Forbes.com

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