1. WHAT IS COVERED CALIFORNIA?
Covered California is the state-run agency established to oversee the health insurance exchange and enroll people for insurance coverage. To review insurance options, go to www.coveredca.com or call 1-800-300-1506. The exchange is scheduled to go online at 8 a.m. Tuesday.
1. WHO WILL BENEFIT FROM THE AFFORDABLE CARE ACT?
Mostly the poor, who will be eligible for Medicaid now that California has agreed to expand the program, and low-income workers who will receive substantial reductions in their health insurance premiums thanks to government subsidies. Middle class and upper-middle income individuals and families who buy their own insurance will receive more comprehensive coverage than is available now, but they also will have to pay for it. Their costs are likely to rise.
1. WHAT IF I DECIDE NOT TO BUY HEALTH INSURANCE?
Consumers have until Dec. 15 for coverage to start Jan. 1. After that, enrollment lasts through the end of March to avoid penalties for 2014. Individuals who opt out of coverage will face a tax penalty of $95 the first year, but it rises to a minimum of $695 by 2016.
1. WHAT BENEFITS WILL INSURANCE COMPANIES BE REQUIRED TO COVER?
The 10 essential benefits required of insurance plans sold on the government exchanges are: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative services and devices; laboratory services; management of chronic diseases, and preventive and wellness services; and pediatric services, including dental and vision care.
1. ARE IMMIGRANTS IN THE COUNTRY ILLEGALLY ELIGIBLE FOR COVERAGE?
No. Immigrants who are in the country illegally will not be eligible to buy insurance through the exchanges and also are ineligible for Medicaid. Legal immigrants, however, can buy insurance through the health care exchanges and are eligible for the subsidies.