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Rescue Plan Act reduces cost for enrolling in Covered California 

If there's ever a time to get health insurance, it's right now.

click to enlarge GET INSURED The cost of complex COVID-19 care can reach hundreds of thousands of dollars for those who aren't insured. Covered California can cost less than $10 a month for many enrollees. - FILE PHOTO COURTESY OF DIGNITY HEALTH
  • File Photo Courtesy Of Dignity Health
  • GET INSURED The cost of complex COVID-19 care can reach hundreds of thousands of dollars for those who aren't insured. Covered California can cost less than $10 a month for many enrollees.

A recent study published by FAIR Health found that uninsured Californians receiving complex inpatient care for COVID-19—those requiring ventilation or admission to the intensive care unit—on average are subject to a charge of more than $460,000. By contrast, the average allowed amount is $127,000: This is the fee that's negotiated between an insurance plan and a provider for in-network services, and it includes both the portion paid by the patient and the health plan, according to FAIR Health. Insured patients typically pay a small fraction of the allowed amount.

"Most Californians get their health care coverage through their job," said James Scullary with Covered California. "You pay a little bit, and your employer picks up the larger amount."

But not everyone fits into this category.

"You've got people out there in the San Luis Obispo area who are entrepreneurs, who are self-employed, who work in the gig economy, who typically don't have health insurance through another source," such as job-based coverage, MediCal, MediCare, or Veterans Affairs, Scullary said.

These are the people who are likely eligible for Covered California, the state's health insurance marketplace established under the federal Affordable Care Act. Yet, there are hundreds of thousands of people not taking advantage of this option.

"Based on data from 2020, we estimated that there was a little bit more than 1 million uninsured Californians who were eligible for financial help through either Covered California or MediCal," Scullary said.

Historically, the biggest barrier stopping people from getting insured has been cost, Scullary said. But thanks to the American Rescue Plan Act (ARPA), Covered California is more affordable now.

"[ARPA] included increased financial help through the Affordable Care Act to help people get covered or stay covered during the pandemic and the recession. So if someone checked a year or two ago and thought, 'I can't make this work in my budget,' they really should check again," Scullary said. "Right now, about two out of every three of our enrollees could get a plan for $10 or less per month."

The deadline for open enrollment in Covered California is coming up quickly on Jan. 31.

"If you don't have coverage, just take a couple of minutes to log on to coveredca.com," Scullary said. "You can find out quickly not only how much financial help you're eligible for, but the plans and options in your area. If you've checked before, check again." Δ

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