2016 Kaiser Permanente Covered California health insurance plans for individuals and families will be available for viewing in October.
Anyone can get Kaiser coverage as long as you live in a Kaiser service area. You can no longer be denied coverage because of a medical condition, and you don’t have to pass a medical exam to qualify for a Kaiser health insurance plan.
2016 Qualifying Events – Situations which allow you to enroll in a Kaiser plan “outside” the Open-Enrollment period:
- Divorce, termination of domestic partnership or civil union.
- Change in full time employment status.
- Loss of employer sponsored insurance.
- Voluntary or involuntary termination of employment.
- Death of parent or spouse.
- Change in dependent status – i.e. dependent child turning 26.
- Existing coverage is being changed to a qualified health plan.
- Domestic Partnership (in states which allow).
- Birth of child.
- Adoption of child.
- Placement for adoption of child.
- Guardianship or court order dependent.
- Permanent move to a new state.
Be sure to enroll by December 31 to receive a January 1, 2015 effective date. After that, the next available effective dates are: February 1st and March 1st. The only way to enroll in a plan after March 1 is if you have a “qualifying event” such as, you are coming off of an employer health insurance plan, or you move to an area where your current plan is not available or if you are moving on or off of MediCal. There are a few other situations but typically if you miss the Open Enrollment period you will not be able to enroll for the balance of the year.
4 Levels of Coverage … With all companies including Kaiser you will see four levels of coverage; Bronze, Silver, Gold and Platinum. Each level provides a different level of coverage to meet your needs. Bronze offering the lowest level, while Platinum is the highest.
All plans will offer the “essential health benefits” which are; doctor visits, hospital care, prescription coverage and maternity care, and will include certain preventive care for no charge.
Enrolling “On and Off the Covered California Exchange .. Enrolling “On” the Covered California Exchange is typically for the individual or family who qualify for a subsidy due to their income level. Individuals and families who do not qualify for a state subsidy, will usually enroll “Off” Covered California (the plans are the same) although the premium amounts are quite different.
Health Care ... Almost everyone gets sick or hurt, or needs some sort of medical help. To get better you usually need care, like seeing a doctor or staying in a hospital or taking prescription medications. Health Care includes many different services such as; Doctors office visits, hospital stays, emergency room visits, X-Ray and Lab, prescription drugs, preventive care, well baby visits, well woman visits, immunizations and screenings.
Health Coverage … Health Insurance is a lot like the insurance people get on their car or home. Some people get their health insurance through their jobs, while others buy it themselves. Without insurance, high medical bills can wipe out savings and even lead to bankruptcy. Insurance helps protect you financially, if you have a serious illness or injury that requires extensive care.
How you Benefit … Peace of mind .. You shouldn’t have to worry how you are going to pay if you get sick, injured or pregnant. Life is unpredictable, but when you have Kaiser, you have more control and you can rest easy knowing you are going to get the care you need.
Care when you need it .. You can see a doctor when you are sick or just need preventive care like a check up or screening. You don’t need to ignore symptoms, or hope they’ll go away. You can get treated before they get worse.
Stay on a Healthy Course .. Preventive care helps you catch minor symptoms before they become problems. Screenings like mammograms and cholesterol level tests can catch problems early, when they are easier to treat.
Questions? Call or email anytime.