It’s that time again…time to enroll in or update your health insurance.
It is very important to take care of our health. We talked to Leticia Vera, Director of Patient Retention and Engagement at TrueCare, about making sure everyone understands how to get or remain covered and stay healthy.
The Programs
There are three types of health coverage assistance individuals can get in the state of California if they meet certain requirements—Medi-Cal, Covered California, or Medicare.
One of the top barriers to getting and keeping this coverage is a “lack of awareness about the different changes that we’ve had in California with health coverage in recent years,” says Leticia Vera.
She adds that the application process can be overwhelming. “We want to make sure that we’re providing that education or the information that is easy to digest with our communities and be here to support with the application process, from the prescreening phase to enrollment and even beyond that,” she says.
“We are not just enrolling individuals or assisting with the process but are also linking them to care, which is the ultimate goal, making sure that individuals are staying healthy by using their benefits,” says Vera.
“I think part of the misinformation still is that there are some individuals or patients who believe that they can choose what plan to apply for.” In reality, enrolling in a plan depends on different criteria.
The good news is, you can get free assistance to enroll in a program or to renew your benefits.
Applying
Vera explains, “We need to make sure that everyone understands that by submitting the application, they’re also going to be required to submit some documentation that varies depending on the cases.” The two most important pieces of documentation are proof of identify and proof of income, such as tax returns.
The final step in enrolling for Medi-Cal or Covered California is to choose a health plan. “It’s one of the requirements. It’s not optional,” says Vera. This step can be confusing, she adds, so TrueCare is available to help, even if you are not a member of TrueCare and don’t plan to use their services. This assistance is free to anyone.
Before someone makes the decision, Vera encourages them to look at the plans side by side to determine which one covers their needs. “Some plans have different processes for referrals, for example.”
Choosing a plan is even more important when individuals are currently under treatment or have a chronic disease they are already in treatment for. “We want to make sure that they’re not choosing a plan where they’re not going to be able to continue the care that they’re currently receiving,” she explains. It is essential for individuals to share all their health information with the person assisting them. That way, the assistant can guide them to the plan that is best for them.
Another point to consider is if an individual already has a medical provider and wants to keep seeing that person. It’s important to make sure that the doctor you already have will take the plan you choose. “We have had patients or clients that choose a plan, but they say, I’m not able to go to my doctor, and I want to continue to go. So, that’s important to be aware of,” Vera emphasizes.
Free bilingual assistance
At TrueCare, “our team members are fully bilingual,” says Vera. “The other good news is that for most applications, the services can be done over the phone,” she adds.
But if someone does need to go to TrueCare for assistance in person, TrueCare provides transportation services. “And that’s good news because if that’s a barrier that is preventing anyone from taking assistance, then that’s something we can work through,” says Vera.
Benefits of Enrolling
“When someone has health insurance, you are more likely to stay on top of your health, in doing what we call preventive care rather than having to wait until you are sick,” says Vera. “Obviously, your health insurance does cover when you are sick, but the good news is that you can prevent illness.” Services covered include checkups, immunizations, and chronic health care.
When individuals keep up with their preventative care, “there is a better chance to stay healthy,” says Vera.
Changes to Coverage: Age and Citizenship
2024 brought changes to Medi-Cal. Before, not every age group was eligible to receive Medi-Cal. In January, all individuals between the ages of 26 to 49 who meet the income requirements became eligible for Medi-Cal, regardless of their immigration status.
Another change is that individuals who do not qualify for Medi-Cal might now qualify for Covered California. However, to qualify for Covered California, you must be a US citizen or have a green card.
On November 1, DACA recipients become eligible for Covered California. Before, “anyone under DACA that was trying to apply for Medi-Cal and didn’t qualify, they were left with no options,” says Vera. Now, this population will be eligible for Covered California if they meet the income requirements.
Help signing up for Medical Coverage
- TrueCare
760-736-6734
760-736-6767
https://truecare.org/programs-resources/health-insurance-assistance
The assistance is completely free
TrueCare assists both TrueCare patients and anyone else that needs the assistance.
- Vista Community Clinic (VCC)
https://www.vistacommunityclinic.org
844-308-5003
- Neighborhood Healthcare
833-867-4642
- Covered California
800-300-1506
Enrollment Dates
- Medicare: Open enrollment: October 15–December 7
- Covered California: November 1, 2024–January 31, 2025
- During this open enrollment window, individuals can apply to one of the programs or change or review the one they already have and make any changes
- For Medicare, individuals can start applying three months before they turn 65 and can do so up to 3 months after they turn 65.
Covered California, Medi-Cal, Medicare
Medi-Cal
This program helps cover health insurance costs for individuals whose income is lower than a specified amount. Under some Medi-Cal plans, individuals pay nothing for health coverage.
To qualify, they must meet requirement of family size and income guidelines.
Individuals can apply all year round. Still, they need to renew their Medi-Cal in the month that they are due for that renewal.
Covered California
Individuals who do not meet the income requirement for Medi-Cal may be eligible for Covered California. This program helps individuals pay for part of their health care plan costs, based on their income.
Life Qualifying Event
There are some instances throughout the year when individuals have special open enrollment if they have a qualifying life event. Please check with TrueCare for more information about Life Qualifying Events.
Medicare
This coverage is for individuals 65 years and older. Individuals sign up beginning three months before they turn 65. If they miss this timeline, they have to sign up during open enrollment.
TrueCare team has a partnership with Medicare brokers who offer assistance enrolling in Medicare at the TrueCare location.
