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Common Health Care Information

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Publicly Funded Programs for Basic Healthcare Government

sponsored (funded) health programs

Not just for people with disabilitieshealthcare for

anyone who qualifies Most are for people

with low incomes

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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

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Financial Eligibility

Each program will have financial eligibility. This may be based onfamily income

family size

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Financial Eligibility

Resources • Money in

savings• Things you own

• Besides your home, one car and personal belongings (clothes)

• Bonds, stocks, etc.

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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

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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

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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

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Does immigrant status matter

Do you have to be a citizen or documented to use this program?

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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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Privately Funded Programs

provided by your employer or that you purchase on your own

Covers health, mental health, emergency care

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Important Terms to know

Health Maintenance Organization

Premium Deductible Co-Pay

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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.

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Premium

The amount you pay to be covered by the healthcare plan

Examples:• Healthy Families• 250% Working

Disabled Program• Private Insurance

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Deductible

The amount you must pay before the insurance begins to pay for care

Examples:• Private insurance

(indemnity)• Share of Cost Medi-Cal

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Co-pay

The amount you must pay each time you go for care

Examples• HMO• Healthy Families