Frequently Asked Questions
The phrase "healthcare reform" refers to the Patient Protection and Affordable Care Act, which was signed into federal law in March 2010, as well as supporting state legislation. It is sometimes referred to as "Obamacare."
The intention of these reforms is to help more people get access to affordable health insurance coverage and better medical care. For most people, the new laws mean expanded access to affordable health insurance and more options for medical care.
Most people will be required to have health insurance starting Jan. 1, 2014, or they will face tax penalties. There are exceptions to this requirement for those with certain religious beliefs, Native American tribal members and those with incomes below a certain level.
Covered California is California's health benefit exchange, sometimes referred to as a "health insurance marketplace." This is a state-run website where people can buy healthcare coverage. It is available to people who currently are uninsured or who are buying insurance on their own, instead of through their employer.
On the Covered California website, you can compare and choose health plans, get answers to questions about the new laws and find out if you are eligible for financial assistance or other programs.
The open enrollment period for exchanges runs Oct. 1, 2013, through March 31, 2014, and coverage purchased there will be effective Jan 1, 2014.
If your health insurance coverage is provided by or purchased through your employer, there's nothing for you to do immediately, other than stay informed. If you work for a company with more than 50 full-time employees that does not currently provide health insurance, you should be aware that changes to your benefits may be coming in the next year. Contact your human resources department for more information.
If you purchase your insurance in the individual health insurance market, you will need to take immediate action during the open enrollment period in order to maintain coverage for care from Cedars-Sinai Medical Center and our physicians. Open enrollment begins Oct. 1, 2013, and concludes March 31, 2014.
Possibly. If you get your insurance through your employer, there should be no need to adjust your coverage options at this time. Check with your human resources department for your company's specific offerings.
If you purchase your own insurance, you can choose to go either through the Covered California marketplace or purchase coverage outside of the exchange. Either way, only a select few plans will provide full coverage for care from Cedars-Sinai Medical Center and our physicians. Click here for more information.
A grandfathered plan is a group health plan that was created — or an individual health insurance policy that was purchased — on or before March 22, 2010.
If you’ve had the same individual insurance coverage since March 22, 2010, you may be able to keep your current benefits through "grandfathering." Please call the member services phone number on the back of your insurance card to see if you qualify.
Yes. Emergency care provided at any emergency room – including Cedars-Sinai's Emergency Department – is covered through all insurance plans, whether they are part of the exchange or not.
I can't afford to buy health insurance or haven't qualified for coverage in the past. What does healthcare reform mean for me?
Things may have changed with the signing of the Affordable Care Act. Insurance companies will no longer be able to deny you coverage based on pre-existing conditions. Also, subsidies may be available through the Covered California health insurance exchange to those who meet income qualifications. Finally, eligibility requirements for government programs such as Medi-Cal are expanding. Please contact Medicare and Medi-Cal if you think you may qualify.
If you don't currently have health insurance, you will need to purchase a policy on your own or through your work by Jan. 1, 2014, in order to avoid government penalties.
Several aspects of the Affordable Care Act have already gone into effect since the act was signed into law in 2010. On Oct. 1, 2013, the open enrollment period begins for people purchasing individual insurance policies either through the exchange or from insurance companies directly. This coverage goes into effect on Jan. 1, 2014. The open enrollment period ends March 31, 2014.
Click here for more details on key features of the Affordable Care Act by year.
For more guidance, click the option that best describes your situation.