Health Insurance in California: Will Healthcare Reform Help You?

Surveys show that many people are still unaware of what health care reform means for them so you may be wondering whether you’ll see any changes when you go to the doctor. With some health care reform already in place and more to come by 2014, you’ll be seeing changes both in doctor care and in insurance coverage.

Will You See Changes In Your Health Insurance In California?

After September 23, 2010, insurance companies can no longer stop you from covering your child, up to the age of 26 if their job doesn’t include health insurance, because of a pre-existing health problem. Insurers are also barred from limiting the amount of coverage you can receive in your lifetime.

If you purchase a new California health insurance plan after September 23, you’ll see even more improvements. With a new plan, you’ll have access to preventive care (including colonoscopies, immunizations, mammograms, as well as pre-natal and baby care) with no out-of-pocket costs. You’ll also have a right to select your own doctor in the insurer network. If you need out-of-network emergency medical services, insurance companies will no longer be allowed to charge you more than if you used in-network services.

Will You See Changes At Your Doctor’s Office?

In California, there’s a big push to get doctors’ offices up to the standards that will be required in 2014. To comply with the nation’s health care reforms, doctors need to convert to what has been called “patient-centered medical homes.” That goes beyond mere record keeping. It leads to a new more proactive way to treat patients.

Backed by a $145,000 grant, a series of seminars are in the making to help doctors improve care decisions and prevent valuable information from being lost. For example, when lab tests are ordered, doctors need to track when the tests are done, whether the patient has the results, and how the results change the patient’s treatment plan.

Susan Hogeland of the California Academy of Family Physicians (CAFP) sees this as a critical component of improving patient care. “There are many places where care decisions can slip through the cracks,” she said. “With an electronic medical record, you can see where it is. That’s critical to the improvement of care, and closing the care loop.”

CAFP has received a grant from the Physicians Foundation to help California physicians research, fund and implement electronic health records (EHR) in their offices through online resources.

Why Primary Care Physicians Are At The Forefront Of Computerization Efforts?

Because they are often the first or only contact many families have with medical personnel, small-staff, family medicine practices may be the backbone of our health care system. Unfortunately, such primary care physicians are also more likely to have the most trouble computerizing their records.

These offices are often the least equipped to invest in such a major change. With a constant flow of patients coming through the office and lower rates of income than specialists, small-office family medicine practices may have a hard time finding both the surplus cash and off-hours time to get a new record-keeping system up and running.

To help, funds are available from Medi-Cal and Medicare to help doctors evaluate which system would work best for them through online resources they can use whenever they have time.

With such changes, California health insurance plans can provide you and your family preventive care at no additional cost. When your doctor gets onboard with electronic health records, you’re also likely to see more effective health care planning. These changes all add up to better care with lower out-of-pocket costs. Now is a great time to comparison shop for health insurance in California.

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