Frequently Asked Questions about the Affordable Care Act

  • What does the Affordable Care Act (ACA, sometimes called ObamaCare or Health Care Reform) mean for me? If you have employer based insurance, not much will change.  There are new patient protections for you and you can keep a child on your plan until age 26.
  • What if I am uninsured?   Good news!  If you are uninsured and you have appropriate immigration status, you may be eligible for Medi-Cal or Covered California.   A lot more people are eligible for Medi-Cal as of January 1, 2014.  Apply beginning October 1, 2013 even if you were turned down for Medi-Cal before.
  • What is Medi-Cal? Medi-Cal pays for medical services for children and adults with limited income and resources.  It is free or very low cost insurance. It includes some dental, pharmacy, and behavioral health.
  • What is Covered California?  Covered California is a new marketplace where you will be able to choose health coverage.  If you make less than about $23,000 for an individual or about $47,000 for a family of four, you may be eligible for subsidies to help you pay for this insurance.
  • Do I have to figure this out myself? No! Many organizations have trained assisters to help you.  Neighborhood based Community Health Centers will have extra staff to help.
  • Do I need to know which program to apply for? No! The community-based application assisters or the online enrollment program will figure this out.  It depends on your income.
  • When do I do this?  Enrollment begins October 1, 2013 and insurance coverage starts January 1, 2014.  If you are eligible for Covered California you must enroll by March 31, 2014. You can enroll in Medi-Cal any time.
  • What information will I need? It is simplest if you have your W-2 form or other income information, a recent tax return, and social security numbers for your family.  You can still apply without these items or if you didn’t file a tax return.
  • What if I don’t have the appropriate immigration status?  You will be enrolled (or re-enrolled) in Healthy San Francisco, which gives you access to providers and services but is not an insurance program.  If you are eligible for full scope insurance through Medi-Cal or Covered California, you must use them instead of Healthy San Francisco.  If you have a citizen child, you can enroll them even if you cannot enroll yourself.
  • Can I stay with my current  provider?  Usually, yes.  Let the person helping you know that you want to stay with your current doctor or clinic. You will need to pick both a health plan (San Francisco Health Plan or Anthem/Blue Cross for Medi-Cal) and a primary health care provider that participates with that plan.  
  • What does it mean to pick a primary health care provider? Your primary health care provider is your medical home – they will provide health care services to you (check-ups, immunizations, management of your diseases, etc.) and help you get to specialists or prescription medicine when needed.