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- Are there more insurance plans that include individual and family coverage for Cedars-Sinai in the 2016 plan year?
- I just learned that the insurance plan I purchased for 2015 doesn’t cover care from Cedars-Sinai in 2016. How do I switch plans?
- What is healthcare reform and the Affordable Care Act?
- What are health insurance exchanges and Covered California?
- What do I need to do now?
- I like going to Cedars-Sinai and my Cedars-Sinai physician. Do I have to change?
- What is grandfathering? How might it affect me?
- What if I'm having a medical emergency? Can I still come to
Cedars-Sinai's Emergency Department?
- I'm on Medicare and/or Medi-Cal. Will my benefits change?
- I can't afford to buy health insurance or haven't qualified for coverage in the past. What does healthcare reform mean for me?
Are there more insurance plans that include individual and family coverage for Cedars-Sinai in the 2016 plan year?
Yes. The following insurers provide individual and family plans with coverage for Cedars-Sinai Medical Center and many of our physicians:
- Anthem Blue Cross PPO (on and off the exchange)
- Blue Shield PPO (on and off the exchange)
You are able to switch your health insurance plan during open enrollment, which runs through Jan. 31, 2016. You can view a list of insurance plans and details of their coverage for Cedars-Sinai or call 1-800-213-3586, 24 hours a day, for more information on plans that provide coverage for care from Cedars-Sinai Medical Center and our physicians.
I just learned that the insurance plan I purchased for 2015 doesn’t cover care from Cedars-Sinai in 2016. How do I switch plans?
Switching plans is easy. You are able to change your health insurance plan — even the insurance provider — during open enrollment, which runs from Nov. 1, 2015, through Jan. 31, 2016. You can also switch plans at other times if you have had a qualifying life event occur (e.g., a marriage or birth).
To switch to a new plan, you can contact the insurance company directly or purchase a plan through a broker.
You can view a list of insurance plans, details of their coverage for Cedars-Sinai and contact information or call 1-800-213-3586, 24 hours a day, for more information on plans that provide coverage for care from Cedars-Sinai Medical Center and our physicians.
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.
As of Jan. 1, 2014, most people are required to have health insurance or they 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 individual and family plans for 2016 runs Nov. 1, 2015, through Jan. 31, 2016.
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 concludes Jan. 31, 2016.
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, confirm that the plan you select provides 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 am eligible for Medicare (traditional or Medicare Advantage)
- I am eligible for Medi-Cal
- I am eligible for BOTH Medicare and Medi-Cal (dual eligible)
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.
*Information updated Dec. 23, 2015.
For more guidance, click the option that best describes your situation.