Family PACT


For language translation click on select language at the top right corner

10 Things Family PACT clients                   
should know about the             
Affordable Care Act
             
Department of Health Care Services Family PACT logo                                                              

1 What is the Affordable Care Act?

The Affordable Care Act, sometimes referred to
as "Obamacare", makes health coverage more
affordable for most low-income Californians. For
some people, health coverage will be free. The
law helps by:

  • Allowing more people to enroll in Medi-Cal.
    Low-income adults who may not have
    qualified before can now receive health
    coverage through Medi-Cal. This includes
    adults without children and people who own
    assets such as a home.
  • Lowering costs. The law provides financial
    help to make private health coverage more
    affordable. If you qualify for financial help, it
    will lower what you pay each month for your
    coverage. It can also lower the out-of-pocket
    costs you pay when getting care.

2  What do the health plans cover?

No health plan can refuse to cover you, even if
you have a pre-existing condition such as
asthma, diabetes, or pregnancy. All health plans
must cover these essential health benefits:

  • Preventive and wellness services
  • Doctor visits
  • Prescription drugs
  • Laboratory services and medical tests
  • Emergency services
  • Maternity and newborn care
  • Hospital stays
  • Rehabilitation services
  • Mental health and substance abuse
    disorder treatment
  • Dental and vision for kids

 

 

 

3  What about birth control?

The law makes birth control free for all
women. All health plans must cover birth
control methods and family planning services
for free. Just like with Family PACT, you do
not have to pay a co-pay, co-insurance, or
deductible for these services.

4  I like my doctor. Can I keep my
    doctor if I enroll in Medi-Cal or
    private health insurance?

If staying with your current doctor is important
to you, check with your doctor's office to see if
they are part of the plan you want to choose.
Also, a list of doctors and hospitals for each
health plan will be posted on the Covered
California website. You can see which plan(s)
your doctor belongs to.

Will Family PACT continue?

Yes. You can remain enrolled in Family PACT
and continue to receive Family PACT services,
as long as you remain eligible and you:

  • Are not in Medi-Cal
  • Are not in Medi-Cal Managed Care
  • Cannot use your health coverage for family
    planning services

For questions directly related to Family PACT,
contact fampact@dhcs.ca.gov or (916) 650-0414.        

6  Can I just keep Family PACT?

The law requires US citizens and legal residents
to have health insurance or pay a fine when they
file taxes. Family PACT is not considered
health insurance.
Family PACT is a limited-
benefits family planning program. You will have
health coverage for all your health care needs
when you enroll through Covered California.

© 2014 California Department of Health Care Services, Office of Family Planning. All rights reserved. Revised 2017                                       
Any one shown in these photos is a model. The photos are used for illustrative purposes only.
For additional copies, visit www.familypact.org

7  What is Covered California?

Covered California is a health insurance
"marketplace" created by the law. You can shop
for and enroll in more affordable health
coverage. And, it is the only place where you
can purchase health insurance using federal
financial assistance to lower costs. With
Covered California you can:

  • See if you qualify to enroll in free health
    coverage through Medi-Cal.
  • If not,
    • Find out how much federal financial
      help you will get.
    • Shop for and compare health plans
      side by side.
    • Choose and enroll in a health plan that
      fits both your budget and health care needs.

8 Where do I go to find out my options
for health coverage and learn more?

There are many ways to get help shopping for
health coverage and enrolling in Medi-Cal or a
health plan. You may:

  • Go on the internet to www.CoveredCA.com;
  • Call 1-800-300-1506
  • Get help from: 
    • Certified enrollment counselors
    • Certified insurance agents
    • Local county human or social services
      offices
    •  Enrollment fairs and events advertised
      locally
  •  Apply and enroll directly in Medi-Cal at
    http://www.benefitscal.org

If you are under age 26, you are eligible for
health coverage under your parent's health
insurance, even if you are married or a student.

ACA Couple 9 When will my health coverage begin?

The sooner you enroll, the sooner your
comprehensive health coverage will begin.

  • You can enroll anytime you become
    eligible for Medi-Cal
  • For enrollment in private health coverage
    using federal financial assistance:
    • You must enroll using Covered
      California.
    • You must enroll once a year during
      open enrollment or within 60 days for
      specil enrollment after you:
      • Lose your health insurance
      • Move to or from another state
      • Get married or divorced
      • Have a baby
      • Self-attest to surviving domestic
        violence and/or spousal
        abandonment

10  What else should I know?

The law requires all U.S. citizens and legal
residents to have health insurance starting in
2014. If you are eligible and don't have
insurance, there is a tax penalty. 

 

 

 

Understanding how health insurance works is confusing for many people.

Here are some important words to know:
Out-of-pocket expenses: 
These are health care costs that you must pay for with your own money.
Monthly premium:  When you buy health insurance, you pay a monthly amount for it called a premium.
Co-payment:  Some plans and some services may require you to pay a "co-pay" when you receive
care.  Usually, you will pay your co-pay before you receive the service.  For example, you may need to
pay a $5 co-pay for an office visit or a prescription drug.
Co-insurance:  Some plans "share the cost" of services with you by requiring you to pay a percentage
of the cost.  For example, if a doctor's visit costs $100, the plan may pay $80 and you may pay $20 in
co-insurance for the visit.  Usually, you are sent a bill for your co-insurance amount after the service is
received.
Deductible:  This is the total amount of money you must pay out-of-pocket when you receive health
care services through your health plan before the insurance starts to pay costs.