Category Archives: Health Insurance
Covered California has set its next Open Enrollment (for 2019 benefit ) from 10/15/18 to 01/15/19. If you will qualify for the financial assistance depending on your household income compared with the Federal Poverty Level (FPL). Please see 2019 FPL table as follow:
加州全保2019年的開放期間是 10/15/18 至 01/15/19， 是否得到保費補助是依每年公佈的聯邦貧窮線標準做計算，新一年度你是否可以得到保費補助？ 請參考2019 數字如附表:
The Marketplace in California, Covered California, has announced its 2019 health plans Benefit Designs as the attached image. Please note Benefits in blue are NOT subject to a deductible, Benefits in blue with a white corner are subject to a deductible after the first three visits.
As you know, Trump’s administration has been trying to repeal/replace the Affordable Care Act but not succeed but do have had some changes. A most noticed one is that the individual mandate will no longer be enforced from 2019, meaning the mandate penalty will be $0 (if your states are not implementing their own penalties).
At this time, the annual open enrollment for benefit year 2019 is just at the corner. In California, the Covered California, has set it beginning 10/15/18 to 01/15/19. Consumers who sign up between 10/15-12/15 will have a January 1, 2019 effective date and if between 12/16-1/15/19 will have a February 1, 2019 effective date.
現在又是接近年度開放期的時候了！在加州2019年開放登記時間已確定在10/15/18 -1/15/19. 若介於10/15-12/15完成登記, 生效日會在19年的1月1號生效，若延至12/16/18-1/15/19完成登記，生效日將19年在2月1號。
To protect beneficiary’s identity, Medicare already started mailing new Medicare cards to all people with Medicare now. Instead of using Social Security Number, the new card will have a new Medicare Number that’s unique to each beneficiary. During the mailing process, Medicare reminds all beneficiaries:
The new card will automatically mail to you and you don’t need to do anything. Once you get your new Medicare card, destroy the old card and start using your new card right away. Your card may arrive at a different time than your friend’s or neighbor’s and Your Medicare coverage and benefits will stay the same.
為了預防日益普遍的身分盜用事件，Medicare 決定全面換新紅藍卡，主要是號碼的重新設計，不再直接使用個人的社安號. 新卡已陸續寄出，Medicare 提醒各位紅藍卡受益人在這換新的過程中：
卡片將自動寄給你, 你不需要做什麼，收到的時間每個人會不一樣，收到後就可將舊卡銷毀， 至於紅藍卡的福利並不因為換卡而有任何改變
What is California’s Single-Payer bill (SB 562) ?
Just think about Medicare, then you will have the idea of the new California health care system “single-payer”. It means all healthcare costs will be paid by a single source, the government.
Senator Bernie Sanders, who already advocated for the system during his run for the presidency and now introduced by California State Senators, Ricardo Lara and Toni Atkins.
Even no plan details and no funding source yet, the picture of the plan is actually much more generous than Medicare and asks about 400 billion budget. It will have more benefits including dental, vision, hearing, mental health, etc. but no out of pocket for patients such as copay or deductible.
什麼是加州 “單一支付“ 醫療制度？
類似65歲以上的紅藍卡保險，新的制度下，醫療費用將由政府支付。這計劃在Senator Bernie Sanders競選總統時即已提出，現因川普政府尋求健保新方案的不確定性由加州議員 Ricardo Lara 及 Toni Atkins再次提出。雖然目前還沒有制度細節和經費來源， 但此新制度理想上要比紅藍卡保險慷慨許多，不但包栝了牙齒眼睛等，連就醫的自付額，分攤費都免除，預計經費將達四千億之多。
It’s about time to receive your 1095 form for your health coverage in 2016. You know there are 3 different 1095 forms but do you know the difference ?
- 1095A, A Statement issued by Covered California It shows who was covered and when. It also shows the subsidy amount you got in 2016 so you will report it with your 2016 taxes.
- 1095B, issued by Health insurance companies to its members who enrolled directly with the companies without any exchange in between which contains who was covered and when.
- 1095C, issued by Employers that offer health coverage to its employees and/or their families with information about who was covered and when.
你很快將收到你的2016 醫療保險的1095表格， 你或已知道他有3種， 但你知道其中的不同嗎 ？
- 1095A 是由Covered California 加州全保發出，發給經由該交換所取得医療保險的人，目的在確認受保的人,受保的計劃及受保期間，受補助金額等
- 1095B 是由保險公司發出，發給直接向該公司投保而未經過交換所的會員，目的在証明是否所參加的計劃合乎歐巴馬健保下強制投保的規定
- 1095C 是由提供團保的雇主所發出，發給它所承保的員工及家屬，確認受保的人和受保的計劃
The Open Enrollment period for 2017 Obamacare health insurance has been official announced as 11/01/2016 to 01/31/2017. If you want to apply or change your coverage for 2017, you can do it starting 11/01/2016 and before the last day 1/31/2017 of the open period. Also, in order to have coverage that begins on 01/10/2017, you need to complete your application before 12/15/2016. If you enroll after the 15th of the month, you’ll have to wait until the month after that for your coverage to start. So, for example, if you enroll on 01/16/17, your coverage would start on 03/01/17. If you miss this window you will have to wait for next open in November 2017 unless you have a special “qualified event”.
Beginning January 1, 2017, All Covered California health plans are required a Primary Care Physician (PCP). A member should choose one or have one matched by their plan. If the plan match one for you, it will be based on the physician you currently have or, if you have not been seeing a specific physician or renewing with a new provider, a physician will be selected according to where you live. A consumer can change to another physician at any time and not required to see the PCP and may continue to access specialists and other providers as they currently do. Consumers will receive notification from their health plan about this change but No action needed at this time.
Covered California unveiled its rates for 2017 on Tuesday this week with a statewide weighted average change 13.2 percent.
However, if consumers switch to “the lowest-cost plan at their same benefit level plan “, Executive Director Peter V. Lee said, “Almost 80 percent of our consumers will either be able to pay less than they are paying now, or see their rates go up by no more than 5 percent. So, “Shopping is going to be more important this year than ever before, That’s the power of shopping.”
本週二加州全保公佈了2017健康計畫費率， 全州平均上漲13.2%，但加州全保提醒消費大眾進行比價, 因為有可能透過轉換至其他同等級計劃, 不但避開漲價甚至付更低, 或小漲5%以內， 所以面對2017新保費, 多比較後再選擇非常重要!