How Health Insurance Works How does health insurance work imagine you have a $100,000 heart surgery which is a covered medical expense...
How Health Insurance Works
How does health insurance work imagine you have a $100,000 heart surgery which is a covered medical expense under your health insurance plan and let's say this health insurance plan has a $1,000 annual deductible 20% coinsurance after deductible a $2,000 out-of-pocket limit and a 2 million dollar annual limit on your health insurance coverage in this video we'll explain how these different components of a health insurance policy work before we begin it's important to note that any health insurance policy purchased after September 23rd, 2010 will not have a lifetime maximum limit on most of the plan benefits and any health insurance policy purchased after January 1st, 2014 will not have an annual limit on most plan benefits the first thing we'll talk about in this post is a deductible
What is a deductible typically a deductible is the amount of money you must pay each year before your health insurance plan starts to pay for covered medical expenses so with a $100,000 heart surgery bill you are responsible for paying the first $1,000 after this $1,000 deductible is met the insurance company will pay a percentage of the bill and you will pay the coinsurance to let's talk about coinsurance what is coinsurance typically coinsurance is a cost-sharing requirement where you are responsible for paying a certain percentage and the insurance company will pay the remaining percentage of the covered medical expenses after your deductible is met
For a health insurance plan with 20% coinsurance once the deductible is met the insurance company will pay 80% of the covered expenses while you pay the remaining 20% until your out-of-pocket limit is reached for the year what is an out-of-pocket limit typically the out-of-pocket limit is a maximum amount you will pay out of your own pocket for covered medical expenses in a given year for a plan with a $2,000 out-of-pocket limit you will pay a one thousand dollar deductible and one thousand dollar coinsurance while the insurance company covers the remaining ninety-eight thousand dollars of the heart surgery bill even if you're hospitalized again in the same year the insurance company will pay 100% of your covered expenses until you reach your annual coverage limit
What is an annual coverage limit some health insurance plans place dollar limits upon the claims an insurance company will pay over the course of a plan year so if you bought an insurance policy with an effective date of July 2011 your plan year would run from July 2011 until June 2012 if you have an annual coverage limit of two million dollars and you have medical bills that cost more than two million dollars during your plan year you would be responsible for paying those bills out of your own pocket once your new plan year begins in July 2012 your deductible coinsurance out-of-pocket limit and annual coverage limits would all reset and the insurance company would once again begin to pay your covered claims beginning September 23rd 2010 the Patient Protection and Affordable Care Act health care reform begins to phase out annual dollar limits starting on September 23rd 2012 annual limits on health insurance plans must be at least a two million dollars by 2014 no new health insurance plan will be permitted to have an annual dollar limit on most covered benefits some health insurance plans purchased before March 23rd 2010 have what is called grandfathered status health insurance plans with
grandfathered status are exempt from several changes required by health care including this phase-out of annual limits on health coverage here's one more concept you should be familiar with some health insurance plans offer co-payments what is a co-payment typically a copayment or copay is a specific flat fee you pay for each medical service such as $30 for an office visit after the $30 copay the insurance company pays a remainder of the covered medical charges sometimes subject to the deductible and
coinsurance certain recommended preventive services immunizations and screenings are covered with no
cost-sharing or co-payments on health insurance plans purchased after March 23rd 2010 let's say you're not feeling well and went to see your doctor who charges $200 for the office visit if your insurance plan has an office visit copay 'men of $30 then you will only be responsible for the $30 and the
the insurance company will cover the remaining 170 dollars but if you purchase your health insurance policy after March 23rd, 2010 and you're due for a routine preventive care screening like a mammogram or colonoscopy you may be able to receive that screening without making a co-payment you can talk to your insurer or you've licensed a health insurance agent if you need help determining whether or not you qualify for a screening without a copay there are five important changes that occurred with individual and family health insurance policies on September 23rd, 2010 those changes are added protection from rate increases insurance companies will need to publicly disclose any rate increases and provide justification before raising your monthly premiums added protection from having insurance canceled an insurance company cannot cancel your policy except in cases of intentional misrepresentations or fraud coverage for preventive care certain recommended preventive services
immunizations and screenings will be covered with no cost-sharing requirement no lifetime maximums on health coverage no lifetime limits on the dollar value of those health benefits deemed to be essential by the Department of Health and Human Services no pre-existing condition exclusions for children if you have children under the age of 19 with pre-existing medical conditions their application for health insurance cannot be declined due to a pre-existing medical condition in some states a child may need to wait for the state's open enrollment period before their
the application can be approved if you have questions that were not covered by this video please contact a licensed be health insurance agent at one eight hundred nine seven seven eight eight six zero
Best Health Insurance Buying Guide
Many people often have confusions between a health insurance plan and a critical illness insurance plan they mistake one for the other in this episode I am going to talk to you about everything that you need to know about these two plans
and help you decide should you have a health insurance plan or should you have a critical illness plan
or you should have both of them this is nri money clinic for you and i am dr chandra khan but
investment consultant and a financial planner
nri money clinic no hype just the right advice
health insurance plan and critical illness insurance plan
these two are entirely different they are not same
people get confused with one with the other that's a different story but in reality these two are entirely different
their purpose is different the way they operate is different the premium you pay for that is different
everything is different let's see one by one
the things you need to know about these two plants a health insurance plan or a medical insurance plan
is a plan which will help you to offset your medical expenses if some person gets into hospital because of some disease
the cost which get attached with that hospitalization is taken care by a health insurance plan it's a reimbursement plan suppose you have a 5 lakh insurance
and your hospital bill is a lack of rupee when you get into the hospital a health insurance plan only reimburses you
the cost of your medical treatment only a critical illness insurance plan on the other hand
has nothing to do with your hospital bills
it's a part of your life insurance policy it's a rider which is added to your life insurance policy a life insurance
pays a certain amount of money called the summer show
to the nominee in the unfortunate event of death of the policy holder if a critical illness rider is added on to it for whatever
the value it is in the event of designated critical illnesses the person who suffers critical illness in this case the policy holder gets a large amount of money for himself i will explain this with the help of a small example let's say that you have a life insurance policy which gives you 300 000 us dollar
as a life insurance and you have put a rider of
100 000 as the critical illness insurance sub limit on this if the policy holder dies the nominee will get three hundred thousand us dollar
instead of that if the policy holder suffers a critical illness in that case the sub limit of 100 000 which is accepted as a critical illness rider
is paid out to the policy holder himself so critical illness insurance has nothing to do with
hospital bills how does it get paid out whenever the person suffers from one of the critical illnesses which are listed in the policies these days you get policies which have
32 to 36 different critical illnesses which have been accepted or listed as critical illnesses the moment a person gets diagnosed with one of these diseases
this entire amount which is mentioned as critical illness benefit
gets paid out to the person now let us look at our problem
the problem is should i buy a health insurance plan
or should i buy a critical illness insurance plan or should i have both of these things let's discuss this and try to find an answer
now first of all health insurance plan is a must
you just can't afford to have no health insurance plan
now if this health insurance plan is given by your employer that is okay if you don't have one i would suggest you must have a health insurance plan if you don't have till now even when you have a health insurance plan and if you are an nri if you are above the age of 45 years of old if your job is not stable i would suggest you
at least have one health insurance plan with a deductible plan or it is called as the top of plan
so you please make sure that you have the one
the benefit that you get in the case of a health insurance plan is if you were to get admitted to hospital or you go to hospital for any treatment the cost associated with this hospital will be reimbursed by this medical insurance
subjected to the upper limit so this is a must that you should have whether you have a critical illness plan or not
now you know that your expenses pertaining to your hospitalization will be taken care by
health insurance plan why should you have a critical illness insurance plan will it not be a duplication the answer is no the criticism illness insurance the purpose here is entirely different
if a person gets diagnosed with one of the critical illnesses which are listed in your policy
a big lump sum amount of money mentioned as some assured
will be released to you it could be hundred thousand fifty thousand whatever the
some assured level you have packed in your policy that amount will get paid to you
what is the purpose of having this large amount of money
as a benefit in critical illness insurance i will explain
critical illnesses are those disease which will not kill you
but they will not allow you to work temporally or
permanently if a person suffers from a critical illness
it is estimated that normally it takes two to four years for him to get back to work
if at all if he goes back to work now this has
very severe consequences when a person suffers from critical illness and if he is not able to go to work what will happen to his job
his employer will be empathetic to him he will express his sympathies but an employment is a commercial organization
it cannot keep you on rolls permanently it will
accommodate you to the extent possible the paid leaves the unpaid leaves the three months
sickly user whatever the benefits that are there in your employment contract the employer will extend you beyond a point
employer will say look this is a commercial organization this cannot run so you need to leave this organization suddenly
you are in a situation where in which you are not dying
you have suffered a critical illness but your
employment is not there that big fat salary what used to come at the end of the month
suddenly starts if you are the sole bread earner of the family now you land into a position where in which the salary that you are getting has stopped but your expenses are not stopping
now the health insurance plan what you have will take care of your expenses related to the hospital
but what happens to your living expenses what happens to your rentals what happens to the emis that you are paying for the properties
what happens to the contribution you are making towards your children's education or for retirement funding or any anything else
you suddenly see you are losing control of your life
now in such a circumstance imagine a large amount of money is being paid to you
it will give you options it will replace that lost income
that you lost from your employment so now you don't have a job
or you don't want to go to job it gives you an option
to stay at home for one two three four years depending on your
critical illness benefit that you have in your plan or depending on your cash position this gives you the option the real purpose of critical illness insurance
is to replace your income it is not for meeting the hospital bills which is obviously taken care by the health insurance therefore
next time you have a doubt in your mind should you have a health insurance or should you have a critical illness insurance my answer to you is you must have both health insurance and the critical illness insurance the health insurance given by your employer is fine
but the critical illness insurance part even if your employer has given for you my suggestion is you have critical illness insurance on your
own i'll be doing a video separately why you cannot count on the critical illness insurance given by your employer that video will get published in a couple of weeks from now but for the time being you just remember you must have both health insurance and the critical illness insurance plan in your portfolio by the way if any of you are looking to
buy a critical illness insurance policy or a life insurance policy or health insurance policy
are looking for a professional help to do your financial planning you can make use of my services as well i have provided my contact number here on the screen
you can reach out to me from any part of the world through a whatsapp message feel free to contact me and make best use of our services
dear viewers if the topic that i discussed today was useful to you give me a thumbs up
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don't forget to share this video with your near and dear ones
i will be back with you with yet another
The Importance of Health Insurance in the Age of COVID-19
thank you for attending this breakout session this session is filled with powerful information to help improve your health
and empower you radio free 102.3 kj lh we are you
family it's a delamar and we're doing our kj lh women's health expo virtually hey everybody
i'm so excited that we're able to do this this year in these unprecedented times
everything has gone virtual and we could not
not do our 20th year as we are celebrating
ladies it's all about you today and today we were able to get our covered california crew to come in and share their wealth of information about what they have going on and how we could actually use their resources and sources
to help us in our everyday lives covet 19 has come in
and seems like it has just turned our world upside down
but the great thing is that we have people that are really looking out for us
and really helping us during this time and that's when these young folks come on in
hey everybody
so i want you to meet everybody family ladies if you're watching right now i want you to meet everybody we're going to start with you my beautiful hi i'm claudia kiti mustamante and i'm the southern california regional field manager
and i work with a wonderful team of people who provide
support to all of our enrollment partners in the southern california region
as well as grassroots support i love it i love it and the next lady hi i'm margo thomas and i'm the head of crenshaw health partners
inc we are a very small
non-profit organization who works with covered california as a part of their navigator program
so we will talk about that a little bit later on
small but mighty
and the gentleman who was stuck with these girls today
i love it i love it tough place to be uh my name is robert blevins i'm a covered california certified insurance agent
i work out of the inland empire i've been working with covered california since the beginning in 2014 and enjoyed getting people enrolled and covered well i tell you what the last time we were all together it was just the beginning i don't think anyone was screaming covet as loudly as they are now
we were just talking about it i i remember
um one of your executives were in town and he was traveling back up north i'm like here take a mask
wear a mask he's like no i don't need then we eventually convinced him to take that mass
i think that was back in like february maybe january february
it was the end of january it was the end of january and he took the mass thank god
little did we know though that covet 19 was actually
uh in the states in november a lot of the research is saying that it was here as early as in october november so um it's it's great that people were taking precautions wearing the mask of course i was probably like only one of the whole airport that had them on me and one other lady at the time when i was traveling in february
and uh but it's so important that we do what we can and great folks like you come together
uh to share with us why it's so important that we need help coverage not because there are certain
not just because there are certain penalties that are involved now that says that
everyone state cover cap state of california have to have
insurance but during these times when coveted 19 is out there
you really want to feel like you have somebody on your side that can help you navigate if you get sick and what to do and i'd like to start with you mrs potty is covered california i get this question all the time and i and the ladies that are listening is it obamacare
what is it exactly
it is obamacare but the actual name is um
covered california and it is the name of the state's exchange
um the exchange is where people can come and find
um find health plans that they can choose from
and make informed choices on the type of health care that they can get but covered california is the name of the exchange
and a lot of people do refer to it as obamacare which is
very positive so but claudia with everything that's happening with covet 19
how has that impacted covered california with
uh enrolling you guys have an enrollment period that's happening right now how is that affecting with covet 19 well um i i must say that um we have had a a fair
a fairly large increase in people enrolling um we are
we are currently in special enrollment we are currently in a special enrollment period
which um ends um until july 31st but um california is trying to evaluate the possibility of extending the covet 19 special enrollment until beyond august if possible but it's again it's under evaluation
well i'm sure a lot of people are hoping that happens because with the penalties that we can now
face and everything let's talk about a little bit about that
what can happen to you if you don't have health insurance
um mr blevins you can also jump in on this i do know that it is the state law now
and that that was initiated in 20 starting 2020
where um there is a state penalty and um the the penalties are seven hundred dollars per individual
if you do not get insurance and two hundred
and is it two hundred and twenty dollar two thousand
two per family
and uh 695 per adult which is anyone over 18 on your
your tax file that hurts your pocket you could easily get insurance with that kind of exactly
you can now encouraging people to to enroll because the cost of the penalty can
easily go toward um the cost of purchasing health care
now what are some of the benefits of having covered california health plans i know the preventative care or just having health insurance
coverage in general what are some of the benefits of that
well some of the benefits are that you can stay healthy
instead of waiting until a disease or illness gets to
a point where it's more expensive to treat it the whole purpose of having the affordable care act that was that people would take better care of themselves get checkups on a regular basis
get that little cough or that little whatever
checked out before it becomes a full-blown problem so
can't go to another place during an emergency
so having health insurance improves your odds of going to a hospital in an accident or other situation where you get treated and get taken care of properly and timely
well let me know can i judge it sure also um for mothers
mothers to be maternity uh care and newborn they can get treated without having to pay
and the same with the preventative care that was mentioned before
um they don't have to pay there's no co-pay that's the advantage of covered california
or obamacare and those are just a few of the benefits
of signing up with uh covered california one of the other benefits are pre-existing conditions
if you have a pre-existing condition you can still apply
and qualify for a covered california health plan and
this didn't exist prior so it's a huge benefit for many people across the state well when you say pre-existing conditions and we talk about covet 19 and the research that shows that african-americans are being really plagued with covet 19 because we have these pre-existing conditions you know it is so good to know that we can get some coverage
you know because we're we're concerned with cobit 19 that's out there we've been told
that these pre-existing conditions make us so much more susceptible and now there's a possibility that there's a possibility we can get this coverage without it without worrying about those that's big definitely
and um you know in the african-american community as we all know
um there are we suffer from significant health disparities such as high blood pressure obesity diabetes and the fact that we can easily just go and apply
and get a health plan and also have enrollers who can help us make informed decisions
around what types of health plans are best for us and
especially the health networks i think it's extremely
beneficial for the um for people in the african-american community to to consider and look at what their options are
now what's the difference between covered california
medicare and medi-cal
i can take that one so medicare is for 65 and above medi-cal and covered california is for everybody from zero to 64. and depending on your age and
income you may qualify for a medicare medical plan
or you'll qualify for a covered california plan but as long as you are a eligible recipient meaning you have employment authorization or green card or your us citizen
everybody qualifies for a plan under that umbrella
it's just whether or not they'll qualify for medi-cal covered california or medicare
for 65 and above with everybody so concerned about
that bottom line that dollar right now you know everyone's uh
looking at how they can save because we don't know what's happening or what's coming
um but you guys are actually helping even more so
financially folks cover their their health coverage that's big one of the things i think people forget is that the covered california's larger name is the affordable care act and a lot of times people forget that without the affordable care act these benefits could cost them hundreds of dollars a month
well above the maximum 10 percent of your income that the affordable care act targets
as a self-employed person if i wanted to get insurance outside of covered california
it could cost me a thousand dollars a month and that's a thousand dollars whether you go to the doctor or not no no it's the affordable care act certainly makes
uh health care affordable for most americans
but robert as an agent when you're when you're um getting folks
uh registered and getting them give them getting them insurance what are the things that you see
that we as the consumer need to consider that we are lacking when we come in how can we be better prepared when we sit in front of you
one i think is just understanding the cost of health care
people forget that they've had benefits through their employer maybe in the past and then when they come in to get coverage through covered california they may still think it's expensive so i often show them that without the federal or state assistance that they receive
that plan for a family of four maybe they're paying 250
without that assistance from the state or the federal government it might cost them 800 or a thousand dollars a month so really to me the importance is the affordable care act
understanding that you're getting federal assistance to make this plan affordable and at the end of the day the goal is to keep people healthy go to the doctor one of the things i say right after i i sign someone up is go get a checkup the checkup is free get a baseline
understand where you're at today so that you can get healthy or stay healthy versus letting a problem evolving become a bigger problem
i i think it's great that you guys are offering more assistance financially because the people
you know they lost their job or they weren't working to begin with they think they can't get insurance or they can't get covered
what do you tell them as an agent what i don't have a job can i get insured and if
i've lost my job during the pandemic what can i do for coverage it's if you're a single person and your income is below about 17
300 a year you're going to qualify for free medi-cal
so depending on those front-line workers the the service workers and the people that are on minimum wage in many many cases when they're collecting unemployment they're going to qualify for free medi-cal
so get that free medi-cal get enrolled and when
you go back to work and you get employer benefits or your income
increases we'll see what you requalify for maybe you're on a covered california plan but with federal and state assistance
but how do you how do you calculate your annual income though like if you were a contract
uh you do contract work your uber driver how do you calculate your income to know what you can afford and if you even qualify
for certain things the best way for those contract employees is to use their tax return
because for self-employed people it's after expenses
so you have your gross income and then you have your expenses
and it's the net that it's qual that is the income that qualifies you for a covered california uh plan so if you if you're in your first year it's kind of tough
um i can tell you just having uh doing taxes as well it's about 30 of your income is tied to expenses as well so we take 30
off your gross number and that's kind of the estimate that we use
to establish your uh your annual payroll and if you're an hourly worker it's kind of simple you just
the hours time the number of hours a week times 52 weeks a year okay so i was telling everyone you know i put on social media that i was going to have you all to come in and talk and i have different folks kind of just shoot me little messages on on my instagram is okay if i read one of the questions they have for me um this one says if my employer covers someone's health insurance for free but they have to but they have to pay for their spouse and children can that person enroll them into a covered california
plan that's a good question that is a good question and it depends it depends
on whether or not the cost of employer benefits
is greater than about nine point seven eight percent of their income why that nine point seven eight somebody up in the big sky figured that number out
but basically i rounded to ten percent so if you're making
fifty thousand dollars a year and your benefits through your employer are going to cost you more than 5
000 a year then it's not affordable and you can use cover
california in their federal assistance but if it's within that 10 percent then you need to go with the employer benefits oh okay
that's good good that's really good stuff i hope i'm gonna i'm gonna text them or
dm them back to tell them they need to your answer is there you gotta watch it and get it
okay so you're working you're in what an inland empire out that way i am um i have an office there and one down in temecula
okay so with african-americans are they enrolling
uh in in the coverage there at a good rate
in in the environment i believe so um you know and the question is always what's a good rate 100
is a good rate and we're not at 100 and that's really where we all want to be so um i don't spend to get resistance from the after african-american community many of them are employed and so they're getting benefits through their employer which is a great thing but for those service workers that aren't
many of them are qualifying for medi-cal and many of them now are out of work and so they're still qualifying for medi-cal or other benefits so
i think the biggest thing we have to do in the african-american community is do better uh getting the word out letting them know that there's federal assistance and state assistance there and the state assistant limits have really increased
so uh there's a lot of help there to make it affordable
i love that i love that margo i'm coming to you girl
okay go ahead claudia go ahead to add to you have to add to what mr bevens is saying code california is
making a concerted push to make sure that we partner with community organizations across the state and with agents such as mr blevins to get the word out to make sure that um people in the african-american community are informed and have
access to be able to apply for healthcare
well i tell you what covered california i've been working with you guys for quite some time and i must say you are all over our radio waves it is not because
they are not pushing the message and i love the fact that
i was talking to you earlier about the different vignettes that you allow us to do in the morning to remind people of the deadlines those things are very very important because when you get busy
uh even though we're in a pandemic everyone seems to think that oh you're just twirling in your thumbs and there's nothing going on you still have things that are coming at you during the pandemic and when you have that radio on and you're you're hearing that message you're hearing that message you got that deadline you got that deadline it does subconsciously register with you that hey
i'm oh that's right i need to get this done so big thank you to cover california for pushing that message as hard as you do
yeah you know one of the ways we've been working recently is also working in phone banks and trying to figure out ways in the virtual
atmosphere to you know to get the word out
you know via organizations like mkjlh and um community non-profits and just even facebook and twitter we are out there and we're trying as much as possible to find
all the types of avenues we can to get the word out i love it i love it i love it
lady margo you ready yes
you brought this up the navigator program
tell me about it and how you guys were able to come together
and make that work for our community okay well
the navigator program is a federally mandated and funded as a federally mandated program and is funded by covered california and we work with or the navigator program
works with faith-based and community-based
organizations such as crenshaw health partners
which is my organization and they work with us because we have the experience of reaching
the diverse populations that do need this insurance
and coverage and information and um because our primary focus principle health partners primary focus is on improving health literacy and promoting health
we were a good fit to be a part of that program
the navigator program provides free assistance
to the average consumer um and we work we focus on reaching out to primarily the underserved communities such as your african-american communities latino communities and the lgbtq uh communities as well as others
so we pretty much the navigator program rounds
out the um the outreach
for covered california
i love it now you guys are located in the mall
but with cover 19 everything's closed down
how are you doing how are you faring over there are you able to still reach folks i mean
what's happening well you know a day now that is a serious challenge yeah um we are located in the baldwin hills crenshaw mall
yeah um next to the eyelash place on the second floor
um but the mall is closed yeah and um even though we are essential workers because
of the work that we do we can't do it at the office
so we have to get creative or try to get creative
right now we're working by phone so if people were looking to get insurance or they they know
that we exist um or they may go online to
um cover california kitty help me with the
with the um url um
yeah find help near you exactly yes yes and so if they find us and they call us they can leave a message if we don't answer and we will definitely get back to them within 24 hours
but in the meantime that's just one way we're we're trying
everything that we can and it's just got to get creative
you have to get creative so you know we are working in collaboration with um other non-profits other faith-based and community-based organizations and um health professionals and we are looking to do quite a few more um or quite a few virtual uh sessions and
when all of this when the
when the shutdown ends because hopefully it will not
shut down completely but when we're able to open the doors again
um people can feel safe about coming to our office because we have already taken the precautions
my um certified enrollment counselors and we refer to them as the cec's come in with a face shield and a face mask
we wipe down everything that has been touched by the client
and we prepare for the next client and we do um
safe distancing so you know for many people
it's it's really comforting to be able to come in or to talk to someone um who can help help them and understand that the challenges that they may be encountering
in um trying to understand this whole insurance
game so to speak um and
that's a part of what the navigator program provides
you know you guys are always out i mean we do events you guys are there and having to be creative
uh with the things that you're doing now i know uh
i'm trying to think what kind of events would be coming up that you could be a part of and
and things like are you guys thinking that far in advance as to what's gonna happen because look just as we go start opening
we gotta close everything down yeah well i need to again i need to reiterate we are still open
that is for sure we are still open but in terms of the events we don't have anything
right now but we are planning on doing collaborations
um with other organizations um as a matter of fact i have one tomorrow with uh usc and the los angeles south chamber of commerce virtual of course so we're doing whatever we can and we're we're working on social media now
covered california has a great toolkit for
social media and i will say as a very small
nonprofit community-based organization it is a challenge for us
but we have to and we are i'm beginning to get more
involved in the whole social media game it's a challenge
and it's a work in progress but you know what i would think if they provide the tools for you can make you look big big big you just got to get in there at it
because i love that i love that they're providing
the tools for you to do it i mean exactly especially
cover california being the organization claudia's as big as you are i love to hear that you have resources available for those that you're working with that you're they're under you you're under their umbrella too it's like they're taking care of you guys too make sure that you
keep doing what you're doing and and you know we really try hard to support our um community enrollers and our agents and provide
and provide them with as many tools as possible the social media guide that margot is talking about ism is is available to any of our enrollers so that they can
use it to be able to um draw people to them
you know the other the other way people can also um and
get information on being able to enroll is the um the
california web page where we have act where they have access to enrollers as well as agents so we have the store we have a find help near you like we talked about earlier
which enables you not only to get gain access to
organizations such as margo's but also enrollers such as mr blevins i love that i love that what are you hearing uh margot when
when you're coming in contact with our community what are the
what are you hearing as far as what are people saying about the insurance are they saying they
they can't afford it or are they just not they just don't have enough information
you guys are giving it to them what can we do to encourage more african americans to
to really know they have this insurance that's available it's coverage that's available to them
well what i will say this is um covet 19 has just altered everybody's life we know that
okay there are so many people who have lost their jobs
um who've had reduced hours um who are collecting unemployment
and although
efforts are being made by the city and the state and
um and organizations to provide food and other basic needs the fact is people are stressed and that's really bottom line they don't even want to think about
insurance so what can we do what i can say is you don't want to think about insurance but you really need to
because the smallest
injury accidents happen injuries happen anything can happen at any time and people
really do need to be aware of that because if that happens
without an insurance you're going to have to pay thousands of dollars for the smallest
injury and people can't afford that um so we talked to them about getting coverage
um about the extension of the premium subsidy
now for this uh 2020 year
of coverage covered california has extended
their premium subsidy have has expanded excuse me their premium
subsidy availability um so that it goes to
a single person um who's making seventy four thousand
nine hundred some odd dollars that may qualify
to get a subsidy whereas before it did not go that high
so it's been extended so that more people can get the help
and um and possibly more money a lot of people who did not know that before um should actually contact us and i say us crenshaw health partners um i'm just putting in a plug if they were to call us
at 310 736
we can help them to determine if they qualify
and how much they will will get it doesn't hurt for them to do that so that's one thing um the fact that people
really need to understand really do need to understand that you need to have some kind of coverage
yeah in spite of the in spite of everything else i'm telling you i i was sharing with you guys before we got started um
last week ended up in er had never been an er
ever in my life uh for i've gone with other people like oh let's take a look girl let's take you to er
but i had to go to er and during covet when you got to go and buy yourself and you know i'm having these these these issues of stress and i can't imagine having to sit in there and they say
well do you have coverage or you know what i mean
or just sit there and stress about that too you never
know when you're going to need insurance you're just always glad
that it's there when you need it well you know
one of one of the essential covers of the affordable care act is mental health coverage so everyone who has a covered california plan has mental health coverage and so you have to wait till you're getting chest pains and go and talk to somebody before you get to that point
and it's covered i was like whoa wait a minute maybe i should go
if there are so many things that are happening with us it would covet you know i
i speak very candidly uh that i care for my mom i'm a caregiver and i cared for her for 12 years she i moved her over here with me 12 years ago and i was not prepared for what the pandemic
i when when everything happened and they shut us all down
i was okay with that i was like oh cool we could i could work from home i don't have to go into the office that was called me but i did not take into consideration
what that would do to a senior breaking her routine
not having to be around other people um just just what it would do to her and it has totally
changed her in the last month and a half i mean
totally and it has stressed me out so badly because
you know i see the changes and there's really nothing that i can do right now and so yeah i then ended up in so you never know what's going to happen with these times these things that we're going through
it is insurance is something that you don't think about until you need to think about it right
that's right robert give us how we can get in touch with you
uh where you are yeah the best way to reach me is uh
on my public cell phone number 909 462-2864
of course if you click on the find local help
on the cover california website and you put in my uh zip code
then you'll find me there too so anyway share with everybody to remind them to get coverage
anything you can some wisdom you want to share with us as we get ready to get out of here
well the one thing i'll say about insurance is that
you can you're always going to need it and a lot of people say well i can go to the free clinic or here
but in an emergency they're going to take you to the hospital
they're going to take you to the hospital and they're going to run up a bill and
a medical bill is one of those things you can't file bankruptcy and get out from under
so it's going to be there and when you put the few dollars that you might have had to spend
for a month i can tell you a heart attack is about a sixty thousand dollar bill if you don't have complications so get that insurance the 100 a month is a lot cheaper than having that big bill sit in front of you and then wonder how you're going to pay it off when now maybe you're sick and can't work the way you used to
that's 60 000 to give you another heart attack
absolutely margo any last thoughts on how we can reach you
yes um well again you can reach us at 310-736-8722
we are our zip code is 9008 and what i'd like to add consider covered california to be like the protective mask
that reduces or prevents those high costs
that people will have to pay yes i love that i love that
claudia kitty bustamante i don't want to say your whole name
i love your name california thank you for everything you do in our community you and cover california you guys come through for us each and every time where would you like to leave with this well i think um the important thing is for people to know that
you know covered california is committed to health equity
and we want to make sure that we step up our efforts to
promoting promoting and encouraging people
to gain access to health care as much as they can and by working with partners such as
um margot with crenshaw health partners and mr blevins and the united empire um we're trying the best we can to to make to make um
the access to health care as as available as possible
i also want to plug covered california because there there are definitely many ways in which people can apply by going to the coveredca.com website they can find help on demand
they can find storefronts near um near them and also
because we are now in a virtual world there are ways in which our enrollment partners are also finding ways to help people virtually
i love that i love that guys thank you so much for joining us this is 20 years we've been doing this can we give ourselves a big round of applause thank you so much for the opportunity to talk definitely
kjlh is our 20th anniversary for our kj lh women's health expo covered california has come through bringing their partners in to make sure that we have all the information as to why you need to be
covered now if you need to click that button right down there and listen to this all over again
otherwise get to dialing and get some insurance all right the deadline is coming up
thank you guys so much for being here with us thank you the kjlh's 20th annual women's health expo
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