Tuesday, August 13, 2013

The California Health Exchange in Focus

In keeping the commitment to align with President Obama affordable health care reforms and initiatives, California will be the first to roll out a revolutionary and new kind of health care system, The California Health Exchange. Starting January 2014, all legal residents of California will be able to purchase different levels of health care from the exchange, or marketplace. Those without employer coverage entirely will also have different options available, mainly depending on income levels, to help keep health care affordable and available to individuals who need it. First and foremost, an essential health benefits plan including very basic health services such as emergency services, hospitalization, prescription drugs, and ambulatory services will be included in every plan available on the exchange. This levels the playing field for people requiring immediate and emergency medical attention. This requirement serves to recognize that the overall and eventual costs associated to treating individuals without any kind of health coverage can add up to cost much more in the long run. If individuals classify as low income or do not have an income, they may become eligible for tax benefits and cost-sharing subsidies not currently offered. In addition, these benefits and cost relief measures carry over to plans for families.

For working individuals and families and all other groups of individuals, different tiered plans will be available to choose from and adapted from the precious metals model, being platinum, gold, silver, and bronze. Individuals are families opting to purchase the highest level of coverage available will pay more monthly, but upfront costs become substantially less when medical care is required. These are the main advantages associated to the platinum or gold levels of health care. The California Health Exchange also includes mid-range coverage to help balance budgets with various health services that are required. These plans are reported to be the most appealing to middle income individuals or families looking to balance budget with assurance with comprehensive health coverage. Alongside employer provided health care plans, the exchange offers the opportunity to possibly gain coverage for services previously unavailable. Catastrophic coverage is available for individuals under 30 years of age, attempting to recognize the specific needs of particular age groups.

Attempting to find better balance in health care costs, the California Health Exchange will be the first in the U.S. to try and hit that mark. Finding better ways to assist those who cannot afford health coverage, help to provide working families a break, offering premium plans to those with the means to pay more, and recognizing the different needs of age groups within California are all slated to take effect early next year. Comprehensive information is already widely available to help make the decision process regarding coverage easier and to help people plan earlier. Researching and asking questions regarding the various options, and the different levels of coverage and inclusion regarding plans are likely the best way to ensure there are no surprises when the new plan rolls out. First and on the frontline of changes to health care, California will make great waves come January, so ride it well by staying informed.

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