Answers about healthcare reform

The Affordable Care Act (ACA) is a nation-wide effort to control healthcare costs and expand insurance coverage. It is the most significant change in national healthcare policy since Medicaid and Medicare were put into place in 1965. While almost everyone is required to have insurance under the law, there are many private and government options and financial help depending on your circumstances.

Here are answers to some questions that have been raised by these complex changes:

Where can I buy insurance in California if I don’t have affordable coverage through my employer?
Covered California is the online marketplace for California where individuals and small businesses can shop and compare health coverage options. If you’d rather shop by phone, call 1-800-300-1506. You can also come to Community Regional Medical Center, 2017 E. Illinois, Building A, Fresno, CA.

More Covered California Resources
Getting coverage: https://www.coveredca.com/getting-covered/
Enrollment assistance: https://www.coveredca.com/hbex/enrollment-assistance-program/
Health Insurance Companies: https://www.coveredca.com/hbex/insurance-companies/
Shop & Compare Tool: https://www.coveredca.com/hbex/toolkit/
Frequently Asked Questions: https://www.coveredca.com/FAQs/index.html

What if I can’t afford insurance?
You may qualify for premium assistance or Medi-Cal, a free plan, through Covered California. Check here to see if you’re eligible: https://www.coveredca.com/coverage-basics/medi-cal.html

Where can I get “face-to-face” enrollment assistance?
The Eligibility Services/MISP office
(one block from Community Regional Medical Center)
8 a.m. to 4:30 p.m.
Monday through Friday

Certified educators provide uninsured and self-pay patients, as well as patients currently enrolled in MISP, with information about the process to enroll for Medi-Cal benefits or how to enroll for coverage through Covered California.

What if I was insured through the County’s Medically Indigent Services Program (MISP)?
In January 2014, Medi-Cal was extended to cover documented persons ages 19-64 who are below 138% of federal poverty level (FPL). In California, for example, one person would qualify with an income of $15,856 or less or a family of four with an income under $32,499. Click here for more FPL Guidelines: http://aspe.hhs.gov/poverty/14poverty.cfm.

This means that virtually all documented patients previously in the MISP will likely have access to subsidized healthcare through the Covered California exchange and patients will need to go there to enroll. Covered California does not have healthcare insurance options for undocumented immigrants.

What if I’m a MISP patient who doesn’t qualify for the expanded Medi-Cal?
Under the current contract, Community provides hospital care for Fresno County inmates and undocumented patients.  However, the County is now evaluating proposals from specialty providers of healthcare for inmates.

Although the ACA does not fund services for undocumented patients, these patients can seek medical services at any of the Federally Qualified Health Centers (FQHCs) in Fresno County. They also may continue to qualify for restricted Medi-Cal benefits intended to cover emergency and family birthing services http://www.dhcs.ca.gov/services/medi-cal/Pages/DoYouQualifyForMedi-Cal.aspx.

Why choose Community Medical Centers when you enroll in Covered California?
When you are comparing plans on the Covered California Healthcare Exchange, you are able to see what hospitals are available under each plan. Make sure you choose a plan that includes Community Medical Centers where you will have access to the highest level of care in the region. Community is a system of three hospitals that partners with UCSF San Francisco School of Medicine – one of the nation’s top medical schools – and has the newest facilities with convenient locations throughout Fresno County.


MISP Office
Community Regional Medical Center
2017 E. Illinois, Building A
Fresno, CA
(559) 459-3848
(559) 600-6212 - to appeal a denial for MISP