20 Common Health Care Information

21 Publicly Funded Programs for Basic Healthcare Government sponsored (funded) health programs Not just for people with disabilities healthcare for anyone who qualifies Most are for people with low incomes

22 Publicly Funded Programs for Special Populations Only for people who have disabilities Medi-Cal for Aged, Blind and Disabled California Children’s Services (CCS) Most are for people with low incomes

23 Financial Eligibility Each program will have financial eligibility. This may be based on family income family size

24 Financial Eligibility Resources Money in savings Things you own Besides your home, one car and personal belongings (clothes) Bonds, stocks, etc.

25 What is the Federal Poverty Level (FPL) Combination of family size and income. A family of 4 who earns $19,350 per year is at 100% FPL $19,350 = 100% FPL

26 What is the Federal Poverty Level (FPL) A family of 4 who earns $48,375 per year is at 250% FPL $48,375 = 250% FPL

27 What is Federal Poverty Level Programs that use FPL have an eligibility level Medi-Cal for children 6-18 without disabilities is 100% FPL Healthy Families is 250% FPL

28 Does immigrant status matter Do you have to be a citizen or documented to use this program?

29 Does immigrant status matter Public Charge count against you for citizenship or a greencard Would your sponsor have to repay for the healthcare you receive?

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31 Privately Funded Programs provided by your employer or that you purchase on your own Covers health, mental health, emergency care

32 Important Terms to know Health Maintenance Organization Premium Deductible Co-Pay

33 Health Maintenance Organization (HMO) all of your care comes from the same group general doctor (primary care) is a gatekeeper. the doctor you see first Need a referral from the gatekeeper to see a specialist pays for all of your well and sick care.

34 Premium The amount you pay to be covered by the healthcare plan Examples: Healthy Families 250% Working Disabled Program Private Insurance

35 Deductible The amount you must pay before the insurance begins to pay for care Examples: Private insurance (indemnity) Share of Cost Medi-Cal

36 Co-pay The amount you must pay each time you go for care Examples HMO Healthy Families