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Common Health Care Information

Common Health Care Information. Publicly Funded Programs for Basic Healthcare. Government sponsored ( funded ) health programs Not just for people with disabilities healthcare for anyone who qualifies Most are for people with low incomes.

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Common Health Care Information

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  1. Common Health Care Information

  2. Publicly Funded Programs for Basic Healthcare • Government sponsored (funded) health programs • Not just for people with disabilities • healthcare for anyone who qualifies • Most are for people with low incomes

  3. Publicly Funded Programs for Special Populations • Only for people who have disabilities • Medi-Cal for Aged, Blind and Disabled • California Children’s Services (CCS) • Most are for people with low incomes

  4. Financial Eligibility • Each program will have financial eligibility. This may be based on • family income • family size

  5. Financial Eligibility • Resources • Money in savings • Things you own • Besides your home, one car and personal belongings (clothes) • Bonds, stocks, etc.

  6. What is the Federal Poverty Level (FPL) • Combination of family size and income. • A family of 4 who earns $19,350 per year is at 100% FPL $19,350 = 100% FPL

  7. What is the Federal Poverty Level (FPL) • A family of 4 who earns $48,375 per year is at 250% FPL $48,375 = 250% FPL

  8. What is Federal Poverty Level • Programs that use FPL have an eligibility level • Medi-Cal for children 6-18 without disabilities is 100% FPL • Healthy Families is 250% FPL

  9. Does immigrant status matter • Do you have to be a citizen or documented to use this program?

  10. Does immigrant status matter • Public Charge • count against you for citizenship or a greencard • Would your sponsor have to repay for the healthcare you receive?

  11. Privately Funded Programs • provided by your employer or that you purchase on your own • Covers health, mental health, emergency care

  12. Important Terms to know • Health Maintenance Organization • Premium • Deductible • Co-Pay

  13. Health Maintenance Organization (HMO) • all of your care comes from the same group • general doctor (primary care) is a gatekeeper. • the doctor you see first • Need a referral from the gatekeeper to see a specialist • pays for all of your well and sick care.

  14. Premium • The amount you pay to be covered by the healthcare plan • Examples: • Healthy Families • 250% Working Disabled Program • Private Insurance

  15. Deductible • The amount you must pay before the insurance begins to pay for care • Examples: • Private insurance (indemnity) • Share of Cost Medi-Cal

  16. Co-pay • The amount you must pay each time you go for care • Examples • HMO • Healthy Families

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