The term “health care reform” refers to the Affordable Care Act — the federal law that was passed in March 2010 — as well as any state laws passed to put it in place. These laws are intended to help more people get affordable health care coverage and receive better medical care.
The Affordable Care Act requires most U.S. citizens and legal immigrants to have a basic level of health coverage beginning January 1, 2014 through an employer, a government health program or a health plan they purchase themselves. Those who do not have health insurance will pay a tax penalty.
Some people won’t have to buy insurance. This includes people with certain religious beliefs, members of Native American tribes, undocumented immigrants, and people who are in prison. People whose income is below a certain level are also not required to buy insurance.
If you qualify, the government will provide financial support — called subsidies — to help some people pay for health coverage or care. This support will be determined by a person’s income level and family size.
If you don’t buy coverage and go without it for three months or longer, you’ll be charged a tax penalty by the government. If you lack coverage for a period of fewer than three months, you will not be charged a penalty for that period of time.
Yes, anyone can get coverage. Insurance companies can no longer deny coverage to anyone who has a medical condition, and you don’t have to pass a medical exam to qualify for coverage.
With Western Health Advantage as your health plan, you can choose from nearly 3,000 primary and specialty care providers as well as 15 hospitals in Northern California. Our members have more choices because they aren't locked into one medical group for specialty care. To locate a list of available physicians, please refer to the WHA's Online Provider Directory.
With our unique Advantage Referral program, you'll have the flexibility to choose from many specialists in our entire network, not just within your particular medical group.
How much you will pay depends on whether or not you qualify for a subsidy. This number is based on your income and family size.
If you have questions relating to your financial assistance, enrollment, demographic changes, such as a change of address, please contact Covered California at 800.300.1506
For questions related to your health coverage benefits or billing, please contact Western Health Advantage Member Services