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Health Insurance and Health Care Resources in San Diego

Health Insurance and Health Care Resources in San Diego. Dancers’ Health Insurance Resource Center A program of The Actors Fund. How can I get health insurance in the San Diego area?. Employment-related coverage. Private purchase plans. Government-subsidized programs.

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Health Insurance and Health Care Resources in San Diego

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  1. Health Insurance and Health Care Resources in San Diego Dancers’ Health Insurance Resource Center A program of The Actors Fund

  2. How can I get health insurance in the San Diego area? • Employment-related coverage. • Private purchase plans. • Government-subsidized programs.

  3. What are my employment-related options? • A job, or a spouse/domestic partner’s job. • Union or Guild coverage. If you get laid off from your job … • COBRA – Continuation of Benefits of Employer or Union Plan for at least 18 months or more under some circumstances (Cal-COBRA).

  4. 60 Days to Decide • People who have been laid off or lose employer coverage have 60 days to elect coverage at their own expense. • “Sticker Shock” COBRA will guarantee continued coverage, but can be very expensive. • COBRA a good option – but if young and healthy, cheaper options may be available.

  5. HIPAA Protection • Cannot be denied coverage if: • 1) you’ve had at least 18 months of continuous insurance coverage, the last day of which was under a group plan • 2) you’ve exhausted any COBRA coverage • 3) you aren’t eligible for any public or group health plans.

  6. I can afford to buy private insurance, but I don’t know what type of plan to get.Words to Know • HMO • PPO • High Deductible (“Catastrophic”) • Health Savings Accounts (HSAs) • Co-pay, Co-Insurance • Premium

  7. Individual Market • The Industry Advantage Health Plan 888-558-4247 • MPTVF Clinics • Bridge to Health www.mptvfund.org

  8. Ways to get coverage • Colleges & Universities and Alumni Associations • Association Plans • Internet Brokers • www.ehealthinsurance.com

  9. Small business insurance www.healthcoverageguide.org

  10. Small Business Tax Credit • Employers with fewer the 25 FTE’s and average wages of less than $50,000 that purchase health insurance for employees are eligible for the tax credit. • To be eligible, employer must contribute at least 50% of the premium cost. • 2010 thru 2013, employers will receive up to 35% of their contribution (25% for tax exempt). 2014, up to 50% (35% for tax exempt).

  11. Pre-Existing Condition Insurance Plan • Help for the Uninsured with Pre-Existing Medical Conditions thru a temporary high-risk pool until January, 2014 • Available to individuals who have not had insurance for prior 6 months. www.pcip.ca.gov

  12. I can’t afford private insurance. Are there any government-subsidized programs that can help me? www.lacountyhelps.org

  13. 4 hospitals, 2 ambulatory care centers and 6 clinicswww.ladhs.org

  14. Medi-Cal • Comprehensive coverage, No Premiums • Eligibility: Low income AND one of the following … disabled, pregnant, blind, over age 65, parent of child under age 21. • As part of health care reform, income will be the sole eligibility requirement in 2014. www.medi-cal.gov

  15. Healthy Families www.healthyfamilies.ca.gov

  16. I have a special health condition. Are there any programs that cover it? • ADAP/CARE/HIPP • HIV+; meds and insurance • www.dhs.ca.gov/ps/ooa/programs/care/adap.htm • AIM • Pregnancy and delivery costs • www.aim.ca.gov • The National Breast & Cervical Cancer Early Detection Program www.cdc.gov/cancer/nbccedp/about.htm

  17. Free, Sliding Scale, and Lower Cost Clinics, etc. • www.minuteclinic.com • Venice Family Clinic • Queens Care • Valley Community • Healthy Way LA

  18. Uninsured Low Income • Community Clinics and Health Centers Performing Artists Clinic Venice Family Clinic Women’s Clinic & Family Counseling Center (310) 203-8899

  19. I am 65 or older. What are the options for people my age? http://www.medicare.gov/

  20. I can’t afford my medications. Can I get them for less or for free? • Pharmacy Checker • Needy Meds www.phamacychecker.com www.needymeds.org

  21. Target/Walmart/Ralphs $4 Generic Drug Programs

  22. Health Care Reform • Major Provisions in 2010 • Dependent child coverage extended to age 26. • Insurance for children with pre-existing conditions. • No lifetime limits. Can’t be cancelled. • New plans include preventive services.

  23. Health Care Reform • 2014 – • Can’t be refused coverage. • Expanded Medi-Cal. • Eligible for subsidies to pay for insurance if income is between 133% and 400% ($43,320) of federal poverty level.

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