Buying health insurance for 2024? It’s a good idea to get up to speed on the new rules and regulations, and how to get or stay covered. So, here’s what you need to know.
More Health Plans to Choose From Through Covered California
Covered California’s pool of quality health insurance companies continues to grow, offering even more affordable brand-name plans for you and your family. The Inland Empire Health Plan joined Covered California, bringing more choices to consumers in the Riverside and San Bernardino counties. Aetna CVS Health, which first joined us in 2023, will begin offering plans in Contra Costa and Alameda counties. Similarly, Health Net will start offering coverage to residents in Imperial County. As a result, we will have a total of 12 health insurance companies across the state to choose from. All residents will have at least two options with over 90% of consumers having four or more insurance providers to pick from.
Medi-Cal for All, Regardless of Immigration Status
Starting 2024, all Californians, regardless of immigration status, can enroll in Medi-Cal if their income qualifies. Over the last few years Medi-Cal has been expanding coverage to include undocumented adult immigrants. Californians under the age of 26 have received this coverage since 2020. Starting January 1st of 2023, these benefits became available to eligible adults ages 26 to 49. And starting this year, Medi-Cal is extended to all qualifying low-income adults 50 years and older. This is just one of many ways the state continues to invest in the overall health equity of its residents.
Medi-Cal Ends Asset Limit Reporting
When determining your eligibility for certain Medi-Cal programs, such as Medi-Cal for people aged 65 or older or for people with disability, it used to be that both your income and your assets were considered as part of your application. This included such things as your bank accounts, property, vehicles, and more. Beginning in July of 2022, the state of California began phasing out the asset test and starting this year eliminated it all together. Historically, this qualifier required people to spend down their assets – sell their car or house – before accessing care through Medi-Cal’s Aged and Disabled program, Medicare Savings Programs, and Long-Term Care programs. Now income-eligible people will be able to access these life-saving benefits regardless of assets owned. Keep in mind, while owning property itself will not be considered, any income paid to you for the use of your property, such as rent, still counts.
Expanded Access to Abortion Care
California is enabling more medical practitioners to perform certain abortion procedures. A new law that took effect on January 1, 2024 allows physician assistants, also known as physician associates, who have completed training and achieved the clinical competency required by law, to perform first-trimester abortions without a supervising physician present. This puts physician assistants on par with nurse practitioners and nurse midwives when it comes to performing an abortion without a doctor present. The new law means fewer barriers and shorter wait times for this care.
No More Surprise Out-of-Pocket Costs
Navigating the cost of health insurance can be a tricky process. It often leaves consumers guessing how much a medical procedure, test, or treatment will cost them after co-pays and deductibles. But now health insurers and employers that offer health plans must provide online calculators for a range of services and drugs. Consumers will enter the information and the calculators produce real-time estimates of a patient’s out-of-pocket cost. And the results are personalized, computing how much of an annual deductible patients still owe and the out-of-pocket limit that applies to their coverage. The amount the insurer would pay if the service were out of network must also be shown.
That said, there is no guarantee the exact final cost will be shown. There can be unforeseen factors during the course of treatment which may include the need for additional services. But consumers will have at least more information than before to make informed decisions about their health.
No Surprise Out-Of-Network Medical Bills
Back in 2022, the No Surprises Act was enacted to help protect consumers with health insurance from costly and unexpected out-of-network medical bills. These expenses typically occur during an emergency when a patient needs care quickly without worrying about who’s in their network or whether they have prior authorization from their health insurance. In these situations, providers that are out-of-network had been permitted to bill patients for any portion not covered by the patient’s insurance – a practice known as balance billing. The No Surprises Act is a federal law that protects people from balance billing expenses related to emergency room visits, air ambulance services, and more. You can find more info here.
Starting in 2024, ground ambulances in California will be barred from this practice, thanks to a new law signed by Gov. Newsom. California is the 14th state to provide protections against balance billing for ground ambulances but a federal committee under the No Surprise Act is looking to address it nationally.