Health Insurance Enrollment

San Ysidro Health has a Health Insurance Hotline (619-600-3000) that provides phone screening and health insurance enrollment appointments to those that qualify for health insurance plans with Covered California & Medi-Cal. The number is 619-600-3000 and it’s available Monday through Friday from 8:00am to 4:30 pm.

San Ysidro Health’s Certified Eligibility Specialists can help you:

  • Apply for Covered California, Medi-Cal.
  • Medi-Cal Health plan Election.
  • Covered California and Medi-Cal annual renewals.
  • Medi-Cal Health Plan Changes (Can be changed at any time during the year)
  • Temporary or Emergency Medi-Cal Coverage under Presumptive Eligibility (based of requirements and medical needs)
  • Update changes in income or household information.


WHAT INFORMATION DO I NEED TO APPLY? 

If you apply on your own or you get assistance from us, you will need the following information. It is recommended that you gather all documents PRIOR to completing the application.

  • Identification – A valid picture ID; California ID or Driver’s license.
  • Social Security Card – Required for those who are requesting coverage.
  • Proof of Immigration – Resident Alien Card (Green Card)
  • If you were born in the United States, a birth certificate or US passport.
  • If you are a naturalized citizen – Certificate of Naturalization or US passport.
  • Financial Information – Last two paycheck stubs & most recent Federal Income Tax, or other proof of income.
  • Proof of California Residency – A bill from SDG&E, water, rent receipt, or mortgage payment.


Additional documents for applicants over 65 yrs
. old (if applicable) Medi-Cal Program only.

  • Financial Institution Accounts; Banks, Savings/loans, Credit Unions.
  • Retirement Accounts; IRA, KEOGH, Annuity, stocks, Bonds, Money Market, Trust Fund(s) Mutual Funds etc.
  • Property (whether live in it or not); Houses, apartments, ranch, land, buildings, mobile homes, or life estates in or outside of the U.S. or the State of California.
  • Vehicles /Recreational Vehicles; list of cars, trucks, motorcycles, airplanes, snowmobiles, or off road vehicles (Even if not running).
  • Other; Jewelry worth more than $100, Mineral rights, Burial Trusts or contracts, Life Insurance, Long term Insurance etc.

Please provide these documents for each family member who is interested in applying for health insurance, or is listed as a dependent on your Federal Income Tax forms.

COVERED CALIFORNIA

LOW COST PLANS

If you don’t qualify for Medi-Cal, you can purchase low-cost private health insurance with the possibility of qualifying for financial assistance to help pay for it. As of 2013, every health insurance plan is required to cover the same services (see 10 Essential Benefits Above) including a FREE annual physical (also called a preventive exam). In San Diego the health insurance plans you can choose from include: 1) Blue Shield 2) Health Net 3) Kaiser 4) Molina and 5) Sharp. The differences between the plans are the doctors and hospitals in the network, extra benefits and out-of pocket costs (co-pays, deductibles).

For those who purchase a plan, the monthly premium cost depends on these factors: 1) Number of people in your household (head of household, spouse, children or dependents); 2) Household Income (combined incomes of all members over the age of 18); 3) Ages of those in need of health insurance; 4) Zip Code and 5) Level of Coverage – you will pay a higher amount if you choose a plan that pays for more of your care.

Financial assistance (called tax credits or subsidies) is available for most people.
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These individuals can receive the “discount” at the time of purchase OR wait to get the credit at the time of tax filing. Many individuals and families may also qualify for tax credits to pay for out-of-pocket expenses (such as co-pays).

You can visit the Covered California website for information on the insurance plans and financial assistance available at: http://www.coveredca.com/

 

HOW IS HEALTH INSURANCE DIFFERENT TODAY?

The Affordable Care Act law provides more protection and benefits than ever before! Many people do not realize that prior to the law passing, insurance companies could deny individuals coverage if they had a chronic condition such as diabetes or cancer; they could raise the cost of monthly premiums at any time for any reason. In other words, the new law protects consumers and prevents health insurance companies from denying coverage or dropping you if you get sick.

As of 2013, all health insurance plans, including Medi-Cal, are required to cover the same 10 Essential Benefits. This makes it easier to compare prices and understand what you are paying for.

 

10 ESSENTIAL BENEFITS

  1. Preventive and wellness services (such as immunizations, health screening tests for Cancer, Diabetes, HIV, etc.), birth control, breast feeding supplies, domestic violence counseling.
  2. Medical services
  3. Emergency services
  4. Hospitalization
  5. Maternity and newborn care
  6. Mental health and substance use disorder services
  7. Prescription drugs
  8. Rehabilitative services and devices
  9. Laboratory services
  10. Pediatric services

 

WHAT IF I NEED ASSISTANCE IN APPLYING FOR HEALTH INSURANCE? IS THERE A COST?

There are various ways to get information and assistance. Regardless of the information out there, it is recommended that you consult with a CERTIFIED enrollment counselor or insurance agent. These individuals are certified by Covered CA to provide FREE counseling and application assistance. You should never be required to pay a fee, so beware of scammers that charge a fee to provide this service.

Visit any of our convenient locations to speak to our Certified Enrollment Specialists

 

WHAT ARE MY HEALTH COVERAGE OPTIONS?

The majority of the population has health insurance through their employer. Others have VA health benefits, Medicare, COBRA or some other type of private insurance. The rest have two other options: Medi-Cal and Covered CA. 

Answer a few questions using the Covered CA Shop & Compare Tool to find out what you qualify for and whether you are eligible for tax credits to reduce the monthly premium. 

 

Medi-Cal

Medi-Cal is California’s Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.

You can apply for Medi-Cal benefits regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability, or veteran status. If you are found (or determined) eligible, you can get Medi-Cal as long as you continue to meet the eligibility requirements

NOTE: Income and CA residency requirements apply for every applicant. For more information on eligibility, click here.

Medi-Cal – has No deadline! Apply any time of the year!

MEDI-CAL IS NOW AVAILABLE TO ALL CHILDREN, REGARDLESS OF IMMIGRATION STATUS

 (Income & CA residency requirements apply) 

Click Here for Details     

If you are uninsured, San Ysidro Health can help you find NO COST or LOW COST health coverage regardless of your income, health or immigration status!

Health Insurance Hotline
(619) 600-3000
Monday – Friday 8:00 am to 4:30 pm

A portion of these services is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government

 

CALL FOR A PRE-QUALIFICATION SCREENING AND TO MAKE AN APPOINTMENT WITH OUR CERTIFIED ELIGIBILITY SPECIALISTS.

619-600-3000