Category Archives: ObamaCare in California

What is CA Single-Payer plan ?

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.

什麼是加州近日通過的醫療制度新方法 “單一支付“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。


2017 Open Enrollment Date 開放期


The Open Enrollment period for 2017 Obamacare health insurance has been official announced as 11/01/2016 to 01/31/2017If 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”.

2017年健保的開放期在11/01/2016至01/31/2017,也就是你要加入2017健保或對目前保單做改变的期間。但你完成申辦的曰期將決定你的起效日,凡是要1/1/17生效的記得要在12/15/16之前完成, 若之後則會在再下個月的一號,即2/1/17生效,1/15/17之後則要等到3/1/17生效,例如你在1/16/17加入,你的生效日就會是3/1/17。過了開放期,要加入就得要有合格的特殊理由了。


PCP matched 選定家庭医生

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.

2017年起,所有加卅全保的計劃都要求要選定家庭医生,你可以自己選或由保險公司根据你的就医經驗或住家所在地替你選,之後可隨時改变,但PPO及EPO並不因此而必須經過家庭医生看診,而是保持目前的直接就医專科医生的方式。消費者近日將收到保險公司寄來的相關通知, 但目前不需做任何行動.


Power of Shopping 比價後再選擇

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!

2017 CC power of shopping

1095A mailed to you 表格已經寄出

If you get your health coverage through Covered Califnornia in 2015, The 1095A, Health Insurance Marketplace statement has been mailed to you. It is an important document for your 2015 tax filing, please review it and remember to include it to your tax person when make your filing.

如果你2015是經由加州全保取得醫療保險, 1095A 表格近日已經寄出給你,這是重要的税務表格,一定要注意保存並在報税時交給你的稅務人員

1095A 2015

Open Enrollment extended開放期延長

Due to a last-minute rush for health coverage, Covered California announced Friday that consumers who start their enrollment process, or make an appointment, by midnight Jan. 31 will have until midnight Feb. 6 to complete the application as long as they are working with a Certified Insurance Agent, Certified Enrollment Counselor.



2016 Health benefits

Have you noticed the benefit change in your 2016 health coverage ? The changes include deductible, copay… check the photo link below to have a look !

注意到2016新一年度医療保險福利的改變了嗎?包括deductible, copay等,下列圖案連結可带你了解

2016 CC standard benefits      2016 CC enhanced benefits


Pay for 2016 Coverage

你今年透過 Covered California 新申請保險或 how to pay 121215renew新計畫嗎?確認能在1/1/2016起效,不要忘記在12/28/15之前完成付款。付款方式很多,點擊右方圖案連結察看:

You have enrolled or renewed for 2016 health coverage through Covered California. Now you need to pay your premium before 12/28/15 to start coverage on 01/01/2016. Click on your plan on the right, for your payment options

2016 Obamacare OEP 開放期

Covered California has set its next Open Enrollment (for 2016 benefit ) from November 1, 2015 to January 31, 2016.  The period will align the open enrollment with the Federally-Facilitated Marketplace. If you will qualify for the financial assistance?  please see the new income guideline as follow:

加州全保2016年的開放期間是 11/01/15 至 1/31/2016, 決定補助額度的所得標準也有所調整,新的年度你可以得到補助嗎?可以得到多少?請參考附表

2016 CC income guideline 0915


SEP for Uninsured 無保族的特殊開放期

Covered California established a limited-time special-enrollment for people who didn’t realize the tax consequences of not having insurance. From Feb. 23 until April 30, 2015, consumers are eligible to apply for health coverage by attesting that they did not realize there was a tax penalty.
2015健保年度開放期已在2/15結束了,無保族除非有合格的除外條件,否則將在報税時支付罰款,為了避免一些人因不了解規定而被罰,加卅全保已為他們開立特殊合格原因,以便他們順利投保不受罰款,但必須在4/30/2015之前Uninsured penalty