The California Patient's Guide
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Chapter IX.
Your Health Care Coverage Options1


Medicare

Medicare is a federal health insurance program that provides benefits for eligible individuals. There are three parts to the program: "Part A" is hospital insurance and "Part B" is medical insurance. Part "C," Medicare+Choice, is a program created by the Balanced Budget Act of 1997 that was designed to give individuals new options in the way they receive health care, cut government spending, increase competition among Medicare providers, and provide new patient protections.

To find out if your are eligible, contact:

Health Insurance Counseling & Advocacy Program (HICAP)
1-800-824-0780 or 1-800-434-0222
http://www.aging.state.ca.us/html/programs/hicap.htm

Other Resources:

  • "It's Your Choice: Are Medicare HMOs Right for You?" is a 27-page booklet that advises people currently in Medicare on the changes taking place in Medicare and what they mean. You can access this guide online at http://www.consumer-action.org.

  • Access the Health Care Financing Administration Web site at: http://www.hcfa.gov/medicare/mcarcnsm.htm.



    Medi-Cal

    Medi-Cal is California's program to pay for medical care for some people receiving public assistance or who have a low income and meet other requirements. It is funded in large part with federal Medicaid funds.

    Pregnant women should apply for Medi-Cal because it may be free for them. If they have more income than Medi-Cal allows, a program called AIM (Access for Infants and Mothers) may help. Call them at 1-800-433-2611.

    To find out if you are eligible and to receive information on how to apply for Medi-Cal, call: 1-877-597-4777.

    You can obtain a Medi-Cal application from the county welfare office or another site in the community such as a clinic.

    Other Resources:

    Health Care Options
    (800) 430-4263 (English and other languages)
    (800) 430-3003 (Spanish)
    (800) 430-7077 (TDD line for hearing impaired)

    Medi-Cal Managed Care Education Project
    (213) 532-3919


    Healthy Families Program

    Healthy Families is a program that provides low-cost health insurance for many low-income children. With Healthy Families a family pays a small amount each month to receive health care for their children.

    To be eligible for this program the applicants must:
  • be low-income, uninsured California resident children ages 1 through 18 who are not eligible for Medi-Cal without a share of cost and who have no other health insurance.
  • have too much income for the child to qualify for "free" Medi-Cal.

    The child cannot have had any private insurance coverage during the three months before they apply to the Healthy Families program (there are a few exceptions).

    The child stays eligible for 12 months continuously once it is decided that he or she is eligible, even if the parents' income changes.

    To apply: Call 1-800-880-5305 for a packet. Many community groups are assisting with applications. See http://healthyfamilies.ca.gov/ for more information.


    Child Health And Disability Prevention Program (CHDP) And California Children Services (CCS)

    CHDP provides early and regular health exams for many low-income children up to 19 years of age; Medi-Cal eligible children up to 21 years of age; and Head Start and State preschool children. CHDP offers services including physical exams, immunizations, vision and hearing testing, lead poisoning testing, nutritional check, teeth and gum check, and some lab tests including sickle cell.

    For more information and to find out if you child qualifies call 1-800-993-CHDP (1-800-933-2437)

    Other Resources:

    To obtain the L.A. Coalition to End Hunger and Homelessness pamphlet: "The People's Guide to Welfare, Health and Other Services," go to http://www.peoplesguide.org on the internet or write to: LACEHH, Attn: Editor, 548 S. Spring Street, Ste. 339, LA, CA 90013. ($0.50 per copy)

    For more information on Medi-Cal for children, Healthy Families and other insurance options for kids who may not qualify for these programs, access the Healthy Kids, Healthy Schools website at: http://www.healthykidsproject.org.

    Consumers Union
    Healthy Kids, Healthy Schools Project Staff
    1535 Mission Street
    San Francisco, CA 94103-2512
    (415) 431-6747
    admin@healthykidsproject.org


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    FOOTNOTES
    1. Reprinted with the permission of the Los Angeles Coalition to End Hunger and Homelessness from "The Peoples Guide to Welfare & Other Services-How to Get Food & Money © 2000 by the L.A. Coalition to End Hunger and Homelessness. See end of this section for information on how to get the complete guide.