As Californians adjust to new public health safeguards in response to the COVID-19 pandemic, Health Access would like to make sure we share practical advice for consumers and proposals for policymakers on care and coverage options. We know things are changing fast so we will update you with information as it comes.
Regardless of your health insurance status, California is waiving all costs associated with the screening, testing, and vaccination of COVID-19. However, if you need follow-up or on-going treatment related to the virus, there are options for your coverage.
Health Access Factsheet: State and Federal Responses to COVID-19
VACCINES ARE FREE TO ALL! Don’t worry about any costs associated with your shot, regardless of insurance coverage, income, or immigration status.
Find out more about how and where to schedule an appointment, and when it will be your turn on California’s Vaccinate all 58 website.
As a member of the statewide Community Vaccine Advisory Committee Health Access is committed to the equitable distribution of the vaccine to all who need it. Read more on Health Access’ blog about the state’s latest efforts to expand vaccinations to Californians age 65 and older.
- The State of California has created a website with more health care information surrounding the Coronavirus which can be found here: https://www.covid19.ca.gov/healthcare
- The CA Department of Health Care Services has launched a free 24/7 Medi-Nurse advice line (877) 409-9052 to answer questions about COVID-19 for anyone who:
- Doesn’t have insurance
- Has Medi-Cal but not a regular doctor or plan to oversee their care
IF YOU CURRENTLY HAVE COVERAGE
If you have health care coverage through an employer, Medi-Cal, Covered California, or Medicare, use it! The State of California has eliminated cost-sharing (co-pays, deductibles, or coinsurance) for all medically necessary screening and testing for COVID-19, including hospital and urgent care visits, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.
Employer coverage: Most health insurers have announced said they will waive patient cost-sharing — copays, coinsurance and deductibles — for testing. And some, such as Kaiser, Cigna and Humana, have gone farther by eliminating cost-sharing for all COVID-19 treatment as well. More information on what each health insurer is doing here.
Covered California: If you have coverage through Covered California and experience a change of income, you may qualify for more financial help to lower the the cost of your coverage. Consumers can report an income change by logging in to their account at CoveredCA.com.
Medi-Cal: California has also announced that if you are on Medi-Cal, all COVID-19 emergency treatment would be covered as well, whether it took place in a hospital or a community clinic.
- DHCS: Coverage of Emergency COVID-19 Inpatient or Outpatient Services
- Health Access Blog: New DHCS Guidance Covers Emergency COVID-19 Treatment For All Medi-Cal Enrollees
IF YOU ARE UNINSURED OR BECOME UNINSURED
Many people in the hospitality, arts and entertainment, restaurant, retail, and other sectors are finding themselves without a job or otherwise losing coverage—but there are options like Medi-Cal and Covered California that can help. Many Californians who were already uninsured are eligible but unaware they qualify for Medi-Cal, or Covered California, or for county-based programs. For those who are uninsured, our patchwork system is problematic, but it can be navigated to find a public program, county safety-net services, a community clinic, or a hospital charity care program that can help connect you with the care you need. In this public health crisis, Californians should not let their insurance status get in the way of getting needed testing or treatment.
Early in 2020, California took steps to ensure that treatment for emergencies related to COVID-19 will be covered by Medi-Cal, whether you are in the program, in “restricted scope”, uninsured, or the treatment is not covered by your current health insurance. This assurance of coverage for COVID-19 treatment will last through the duration of the public health emergency. This is now the COVID-19 uninsured group program.
The Federal CARES Act may affect you income levels and eligibility for these programs if you qualify for unemployment insurance. Read more in this Health Access Blog: How the Federal CARES Act May Affect Your Health Coverage
Medi-Cal is a lifeline not just for the currently 13 million Californians with low or no income, but for those who may lose income and coverage in the coming months. Medi-Cal enrollment is open year-round and we encourage those eligible to sign-up as soon as possible.
Covered California has established a new special-enrollment period which allows uninsured individuals to sign up for coverage without needing to meet the normal qualifying life events, such as recent loss of coverage or moving. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through May 15, 2021 and have their coverage begin on the first of the following month.
Covered California can provide financial help for consumers who are not eligible for Medi-Cal’s income limits. The costs may be lower than you thought as new state subsidies may help reduce premiums for eligible Californians who make up to $76,000 per year, or up to $157,000 per year for a family of four.
Visit www.CoveredCA.com or call 800-300-1506 to check your eligibility and options.
- Health Access Blog: California Expands Emergency COVID-19 Treatment Coverage
- Department of Managed Health Care (DMHC): Coverage Options Fact Sheet
- DHCS: Ways to Apply for Medi-Cal
- Covered California
IF YOU OR A FAMILY MEMBER ARE UNDOCUMENTED
Public programs should not exclude any group, including immigrants, from primary and preventive care, particularly in a public health situation like this. We will not successfully combat coronavirus if our immigrant communities are concerned about seeking needed care, getting tested, and getting a bill afterward.
If you are one of the 1 million undocumented Californians currently enrolled in “restricted scope” Medi-Cal, DHCS has announced that all COVID-19 testing and emergency related treatment will be covered for this population as well. While this is a step in the right direction, this does not replace the need for on-going, comprehensive coverage.
Currently, our Medi-Cal program covers all income-eligible children and young adults up to age 26 regardless of immigration status. In January’s state budget, Governor Newsom recommended that income-eligible seniors be included in Medi-Cal regardless of immigration status. We should accelerate that expansion to take care of our seniors, who are a high risk group that will absolutely need care and coverage at this time, for themselves and the hospitals that are serving them. Our health care system is stronger when everyone is included, getting screened, tested, and treated, as soon as possible. Learn more about our work towards #Health4All.
- California Immigrant Guide + Listos California : COVID-19 – Guidance for Immigrant Californians
- California Immigrant Policy Center (CIPC): COVID-19 Resource Guide for Immigrants in California
- California Department of Public Health (CDPH): Guidance for Immigrant Communities
- California Immigrant Youth Justice Alliance: COVID-19 resources for undocumented Californians
- Para obtener información en español, visite nuestra página de el Coronavirus 2019 (COVID-19).
Directing health plans to have zero cost sharing for testing, emergency treatment, and vaccines is a good first step.
California has sought to stop surprise medical bills, ensure access to medically necessary treatments in a timely manner, and more. California’s consumer protections efforts are critical, but we will need additional action at the state and federal level to ensure people have the rights to get the care they need without an unexpected bill.
This pandemic will hit certain California communities hardest. Those who are disadvantaged due to chronic health conditions, housing insecurity, age, income, race, immigration status, and more will need to be of greater focus in our outreach and prevention efforts. The state’s response must address health equity concerns by making sure that public health messaging includes information about affected groups and communities in languages and contexts they understand, directing additional funding to community health centers that serve disproportionately impacted communities and partnering with trusted messengers to share information.
- California LGBTQ Health and Human Services Network: COVID-19 information for the LGBTQ community
- Korean Community Center (collaborated with two other Korean American non-profits to provide limited-English proficient communities with wrap-around health and social services) Here is their Response to COVID-19
- Roots Community Health Center became a COVID-19 testing site and provides mental health, food distribution and housing services for its clients. Follow: COVID-19 for more information
- Black Women for Wellness located in Los Angeles, CA developed wellness guide for the community
PRIORITIZING PEOPLE NOW AND PREPARING FOR THE NEXT PANDEMIC
Ultimately, to prepare for the next pandemic we need a universal health system focused on prevention and public health, rather than profit. Until then:
- Congress needs to continue to act to provide the resources to both slow the spread of the coronavirus and provide the social safety net supports for those dislocated by it through both health and economic impacts.
- California needs to continue its path to expand coverage and affordability assistance, and take other steps administratively and legislatively to ensure the access, affordability, and sustainability of our health system. Setting up systems now, from a new health payments database to new Office of Health Care Affordability, will help California have a sustainable system for the future.
It’s inspirational to see so many communities and institutions respond to this public health situation. Perhaps at no other time have so many Americans thought so much about health system capacity, as we take significant action to “flatten the curve” so our hospitals and respirators are not overwhelmed at once. As we finally start thinking of health care as a system–rather than a commodity–we should take the steps needed to strengthen that system by making it universal, sustainable, accessible, accountable, and ready for the next pandemic.