Category Archives: ObamaCare in California

2019 FPL Table 聯邦貧窮線標準

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:


2019 CA health Benefit Designs 醫療福利

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.

加州全保已公佈2019 年的醫療福利如附圖. 請注意其中藍色的部分是不需要滿足deductible 的,藍色但右上角是白色三角形的是在三次看診以後開始適用deductible.

2019 ACA 開放期 Open Enrollment in CA

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.

正如你所知,川普政府上來以後積極想改變甚至推翻歐巴馬健保的努力並沒有成功,但確實也有了一些改變. 其中最為大眾所關心的就是2019起強制保險的罰款將減為$0(但各州也可自訂他們自己的罰款)。

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。

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 “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。

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