There’s a lot more to the Affordable Care Act than buying private health insurance through an exchange marketplace like www.CoveredCA.com.
Four kinds of public benefits can help people get the medical care they need:
- Subsidized premiums and co-pays for private health insurance purchased through an exchange. Commercial insurers issue these policies, not the government.
- Medicare, for people who have contributed the necessary number of quarters during their years of employment. Medicare Set-Asides are required when a Medicare beneficiary settles a claim for future medical care.
- Expanded Medi-Cal for people with low income; there is no asset limit, no requirement for a set-aside
- Traditional Medi-Cal for the indigent; there are income and asset limits, no requirement for a set-aside
These types of benefits are frequently confused, especially because the names are so similar. For optimal settlement of a Workers Compensation case, you need to know the injured worker’s eligibility for these plans.