Frequently Asked Questions

I already chose a new insurance plan. Now, more plans are available that include Cedars-Sinai. Can I switch to another plan? Or am I stuck?

First, if you want your coverage to go into effect on Jan. 1, 2014, you must enroll in the plan that you want by the end of the day on Monday, Dec. 23, 2014. Insurance brokers are able to cancel policies purchased on the Covered California exchange through Dec. 23.

If you have not paid your first month’s premium for the plan you want to cancel, you need to contact the insurer directly or a broker, then enroll in the plan you desire – paying the premium for the plan that you want. Also, you need to contact the plan that you originally signed up for and let them know that you will not be paying the premium and you want to cancel the policy.

If you have paid your first month’s premium for the insurance plan that you want to cancel, there are two steps you need to take.

  1. You can enroll in the plan that you want by the 15th of the month for it to go into effect the following month. (i.e., Jan. 15 for Feb. 1 effective date, Feb. 15 for March 1 effective date, or March 15 for April 1 effective date) Depending on the effective date of your new plan, you may be covered by two plans for a period of time until the first plan is cancelled.
  2. To cancel the original policy that you no longer want, you need to send a cancellation letter to the insurer with evidence of your enrollment in the other plan, if possible. If you do not actively cancel the first policy, you can create liability for yourself as some insurers will attempt to collect premiums for a number of months after you stop paying.

You cannot switch plans after the end of open enrollment, which is March 31, 2014.

What is healthcare reform and the Affordable Care Act?

The phrase "healthcare reform" refers to the Patient Protection and Affordable Care Act, which was signed into federal law in March 2010, as well as supporting state legislation. It is sometimes referred to as "Obamacare."

The intention of these reforms is to help more people get access to affordable health insurance coverage and better medical care. For most people, the new laws mean expanded access to affordable health insurance and more options for medical care.

Most people will be required to have health insurance starting Jan. 1, 2014, or they will face tax penalties. There are exceptions to this requirement for those with certain religious beliefs, Native American tribal members and those with incomes below a certain level.

What are health insurance exchanges and Covered California?

Covered California is California's health benefit exchange, sometimes referred to as a "health insurance marketplace." This is a state-run website where people can buy healthcare coverage. It is available to people who currently are uninsured or who are buying insurance on their own, instead of through their employer.

On the Covered California website, you can compare and choose health plans, get answers to questions about the new laws and find out if you are eligible for financial assistance or other programs.

The open enrollment period for exchanges runs Oct. 1, 2013, through March 31, 2014, and coverage purchased there will be effective Jan 1, 2014.

What do I need to do now?

If your health insurance coverage is provided by or purchased through your employer, there's nothing for you to do immediately, other than stay informed. If you work for a company with more than 50 full-time employees that does not currently provide health insurance, you should be aware that changes to your benefits may be coming in the next year. Contact your human resources department for more information.

If you purchase your insurance in the individual health insurance market, you will need to take immediate action during the open enrollment period in order to maintain coverage for care from Cedars-Sinai Medical Center and our physicians. Open enrollment begins Oct. 1, 2013, and concludes March 31, 2014.

I like going to Cedars-Sinai and my Cedars-Sinai physician. Do I have to change?

Possibly. If you get your insurance through your employer, there should be no need to adjust your coverage options at this time. Check with your human resources department for your company's specific offerings.

If you purchase your own insurance, you can choose to go either through the Covered California marketplace or purchase coverage outside of the exchange. Either way, only a select few plans will provide full coverage for care from Cedars-Sinai Medical Center and our physicians. Click here for more information.

What is grandfathering? How might it affect me?

A grandfathered plan is a group health plan that was created — or an individual health insurance policy that was purchased — on or before March 22, 2010.

If you’ve had the same individual insurance coverage since March 22, 2010, you may be able to keep your current benefits through "grandfathering." Please call the member services phone number on the back of your insurance card to see if you qualify.

What if I'm having a medical emergency? Can I still come to Cedars-Sinai's Emergency Department?

Yes. Emergency care provided at any emergency room – including Cedars-Sinai's Emergency Department – is covered through all insurance plans, whether they are part of the exchange or not.

I'm on Medicare and/or Medi-Cal. Will my benefits change?

If you have Medicare or Medi-Cal, your coverage likely will remain the same. Click here for more information and resources.

I can't afford to buy health insurance or haven't qualified for coverage in the past. What does healthcare reform mean for me?

Things may have changed with the signing of the Affordable Care Act. Insurance companies will no longer be able to deny you coverage based on pre-existing conditions. Also, subsidies may be available through the Covered California health insurance exchange to those who meet income qualifications. Finally, eligibility requirements for government programs such as Medi-Cal are expanding. Please contact Medicare and Medi-Cal if you think you may qualify.

If you don't currently have health insurance, you will need to purchase a policy on your own or through your work by Jan. 1, 2014, in order to avoid government penalties.

When are these changes going into effect?

Several aspects of the Affordable Care Act have already gone into effect since the act was signed into law in 2010. On Oct. 1, 2013, the open enrollment period begins for people purchasing individual insurance policies either through the exchange or from insurance companies directly. This coverage goes into effect on Jan. 1, 2014. The open enrollment period ends March 31, 2014.

Click here for more details on key features of the Affordable Care Act by year.

For more guidance, click the option that best describes your situation.

I Get My Health Insurance Through My Employer

I Buy Health Insurance On My Own

I Have Medicare or Medi-Cal

I Don’t Have Health Insurance