Open Enrollment for Covered California Ends on January 31, 2017
Many Californians without health insurance coverage through their employers
are able to purchase it online through
Covered California, our state's health insurance exchange. Please use
Covered California's Shop and Compare Tool for more information or visit Covered California’s website at
www.coveredca.com. Open enrollment for 2017 health insurance plans through Covered California
ends on January 31, 2017.
Under the Affordable Care Act, insurance companies are no longer able to
deny you coverage based on pre-existing conditions. There also may be
subsidies through Covered California to assist you with the cost of healthcare
for those who meet the income eligibility requirements.
Access to Hoag is available through the following Covered CA Plans:
- Blue Shield PPO Bronze, Silver, Gold or Platinum Plans
- Blue Shield PPO Bronze Plans on Small Business Health Options Program (SHOP) Exchange
- Blue Shield of California HMO (Trio)
- Oscar EPO
- Hoag will remain a Tier 2 provider for Anthem Blue Cross PPO through December 31, 2016.
Please note that Hoag will be out of network for any Covered California
plan that is NOT listed above.
You can access Hoag through
individual health plans outside the exchange as well.
The following guide helps answer frequently asked questions:
What exchange-based health plans is Hoag participating in?
Access to Hoag is available through the Blue Shield PPO Bronze, Silver,
Gold or Platinum Plans, Oscar EPO, and Blue Shield of California HMO (Trio).
And for small business through Small Business Health Options Programs
(SHOP) Blue Shield PPO Bronze Plans. All other exchange plans are subject
to "out of network" benefit and physician referral. Visit the Covered
California website at www.coveredca.com to apply and ensure your access to Hoag.
Who qualifies for a subsidy to help pay for premiums?
Subsidies vary based on income and family size, and are in the form of
tax credits that will be advanced, meaning that each month you will only
have to pay that part of the premium that is not subsidized. To learn
more about subsidies visit Covered California's website at www.coveredca.com.
How does the Health Exchange affect me if I currently use Medicare or Medi-Cal?
If you have insurance through Medicare then changes to individual insurance
(Covered CA) may not apply to you; however we encourage you to contact
the Hoag Personal Service Team to ensure your ongoing access to Hoag 800-400-HOAG (4624).
Medicare plans change annually so if you are a current Medicare member
or new to Medicare this year, you can direct questions to
www.medicare.gov or call 800-MEDICARE (800-633-4227).
If you currently access your Medicare health insurance through your employer please
Hoag offers community education classes to assist with Medicare enrollment
and finding the plan that best fits your needs.
Medi-Cal is California’s state program which offers medical services
for children and adults with limited resources. Eligibility requirements
for Medi-Cal are currently expanding. To check eligibility or for a list
of participating physicians please go to www.dhcs.ca.gov or call 800-541-5555.
To see if you are eligible for Medi-Cal, go to
How much do people pay if they don't have health insurance?
Most citizens and legal residents are required to have coverage or pay
a penalty. Some people may be exempt, including those who are uninsured
for less than three months or who have to pay more than 8 percent of their
household income for premiums.
What are the essential benefits health plans must provide in 2017?
Physicians and other ambulatory patient services, emergency services, hospitalization,
maternity and newborn care, mental health and substance abuse services
(including behavioral health treatment), prescription drugs, rehabilitative
services and devices, laboratory services, preventive and wellness services
and chronic disease management, and pediatrics services including oral
and vision care.
How can I find out more information?
You can visit the Covered California website at www.coveredca.com or