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April 2013 Presented by: Ed Kiryczun

April 2013 Presented by: Ed Kiryczun. Health Care Reform. How Is Access to Health Care Changing?. Low and Medium income families will have access to more affordable Health Care Coverage Medi-Cal is being expanded and simplified Health Insurance Plans are accessible at lower costs

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April 2013 Presented by: Ed Kiryczun

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  1. April 2013Presented by: Ed Kiryczun Health Care Reform

  2. How Is Access to Health Care Changing? • Low and Medium income families will have access to more affordable Health Care Coverage • Medi-Cal is being expanded and simplified • Health Insurance Plans are accessible at lower costs • And - for many low income individuals and families the premiums can be off-set by subsidies • Moderate income individuals can access more complete and affordable coverage also

  3. Changes to Medi-Cal • Medi-Cal will be based on income • Up to 138% FPL • Legal Permanent Resident • No asset test • Applying for and staying on Medi-Cal is streamlined • Income Based on MAGI (Modified Adjusted Gross Income) • Verified electronically when possible • Create “administrative” Renewal process • Adds non-disabled adults without dependants as a new, mandatory coverage group

  4. Health Care Coverage for those making above 138% FPL • HealthCare Exchange – Covered California • Offers: Advanced Premium Tax Credit (APTC) to purchase insurance policies • Subsidize for 138-400% FPL • Uses new Modified Adjusted Gross Income (MAGI) • Subsidize based on “Sliding scale” • Unsubsidized coverage at affordable rates • For those making 401% FPL and higher

  5. No wrong door • HSA • Walk in, Mail in, Call or go-on line • Will screen and enroll in any of the coverage programs • Responsible for Medi-Cal application processing and case maintenance • Covered California • Apply on line or over the phone for Health Coverage programs • CC network of assistors and navigators • Responsible for APTC and Unsubsidized applications and case maintenance • Those found Medi-Cal eligible forwarded to County for processing

  6. Integrating Programs helps address family's needs comprehensively • Nearly everyone eligible for CalFresh will be eligible for Medi-Cal • Most newly eligible for MAGI-based Medi-Cal will be eligible for CalFresh • Opportunities to integrate across other programs • CalWORKS • Employment and Vocational Services • Children and Family Service • Shelters, etc. • Opens “gateway” for many to Behavioral Health Services and Substance Abuse Services

  7. Implementation: Key Dates • April – October HSA develops policies and procedures for new programs • September – HSA Community Partners Health Care Reform Eligibility Forum • October 1 – Open Enrollment for APTC and Unsubsidized program opens (ends March 31, 2014) • January 1, 2014 – New Medi-Cal rules take effect

  8. Thank you!

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