Medi-Cal: California residents can apply for Medi-Cal year-round. We can assist San Luis Obispo County residents with Medi-Cal applications. 

Covered California: If you do not qualify for Medi-Cal, we can help you enroll in coverage through Covered California, California’s online health insurance marketplace. Our staff can help you complete an application and decide which insurance plan is right for you. Legal California residents age 19-64 may apply for insurance during the open enrollment period each year, which generally extends from November 1 through January 31. There are some exceptions. You may qualify to enroll at other times of year if you experience certain life events such as marriage or the loss of other insurance coverage. For a list of life changes that may qualify you for special enrollment, please see “Do I Qualify for Special Enrollment for Health Insurance?”

Covered California offers free or low-cost insurance during an open enrollment period every year, and at other times if you experience certain life events. You must enroll within 60 days of the event. Qualifying life events to obtain new health insurance coverage include:

• Losing your health care coverage
• Marriage or domestic partnership
• Adding to your family through birth, fostering, or adoption
• Permanent move to or within California with a gain of new health plans from which to choose
• Release from active military duty
• Release from jail
• Newly gained citizenship or lawful presence
• Divorce or loss of a dependent

Call your Medi-Cal case worker in the county you have moved away from, and request an “Inter County Transfer.” It is best to do this before you move, if possible. You will need to know the address you are moving to in order to start the transfer. If you do not know your caseworker, call your county's Department of Social Services (in the county you are leaving) and ask for the daily duty worker. You will need your Social Security Number and your birth date.

The phone number for the Department of Social Services in San Luis Obispo County is: 800-834-3002.

No, it does not. However, any time your income increases or you get a new job, you should report this to your case worker so it can be determined if you are still eligible.

Medi-Cal renewal takes place a year from when you first enroll, and every year after that. Income verifications must occur at that time. Be sure your worker has your address, so that you will receive any notices from Medi-Cal in the mail.

You can find out by contacting Covered California directly, or our staff can help you find options and compare plans.

To get information directly from Covered California – It is free to find out your options, and you are under no obligation to apply. You can do your own online comparison at CoveredCA.com. Choose “Shop and Compare” and follow the prompts. You will need to know your annual income. For 2018, three medical insurance plans are available in San Luis Obispo County: Medi-Cal, Blue Shield of CA HMO and Blue Shield of CA PPO. You can also call Covered California at 800-300-1506 for assistance.

To get help from our staff – We can help explain options and compare plans in the office. To make an appointment to meet with us, call 805-781-4838 or contact us by email.

It may cost less than you think. Some plans have no or very low monthly costs. You can gather information and compare costs without any obligation to choose a plan.

When choosing a plan, here are some things to think about:

• What types of medical services might I need in the next year?  Are these covered by the plans I am considering and at what cost?
• Do the physicians I wish to see accept the plan I am considering? (This question might be answered by the billing staff at the physician’s office.)

To check costs, you can do your own online comparison at CoveredCA.com. Choose “Shop and Compare” and follow the prompts. You can also call Covered California at 800-300-1506 or have a consultation in our office. To make an appointment with our staff to review costs and options, call 805-781-4838 or contact us by email.

To enroll for health insurance offered outside your employer, you will need:

• government-issued picture ID
• proof of legal residency
• proof of your income (a previous year tax return works well if you have that available)
• your Social Security card or number

To enroll, you have several options:

• Enroll yourself online at CoveredCA.com
• Get assistance and enroll by phone at 800-300-1506
• Get in-person assistance from our staff to complete your enrollment. Call 805-781-4838 or contact us by email to make an appointment.

Language interpretive services are available through Covered California and at our office. 

If you are having a medical emergency: Go to the nearest hospital emergency room. The hospital will treat you without insurance. They may also help you apply for emergency insurance if you meet income criteria.

If it is not an emergency: contact our staff for help in finding free or low-cost health care and re-enrolling in insurance. Call us at 805-781-4838 to get started.

 The penalty for not having coverage the entire year will be at least $850 per adult and $425 per dependent child under 18 in the household when you file your 2022 state income tax return in 2023. A family of four that goes uninsured for the whole year would face a penalty of at least $2,550.

The penalty will be applied by the California Franchise Tax Board. For information about the penalty, including the amount your family could owe for not having coverage, visit the Franchise Tax Board’s website and use their Penalty Estimator Tool.

For Covered California, the lowest-cost plan would be the lowest-cost Bronze plan available to the individual. Learn more about tax penalty details from Covered California. 

If you have no known health problems and do not think you will need to see a doctor or take medications during the year, then insurance is a safeguard in case of unexpected medical problems or an accident. There are free or low cost options that may still fit your budget and protect you from large, unexpected medical costs which can ruin someone’s budget or savings. Most insurance plans now have a “wellness benefit” that allows free preventive screenings and can help you get care sooner and stay healthier longer if there is something wrong. Some conditions are “silent” and may not be apparent without screening.

Find out more about free preventative services available through health insurance, or discuss with our navigation team at 805-781-4815.

If you are having a medical emergency: go to the nearest hospital emergency room. You will receive care regardless of residency status or ability to pay.

If it is not an emergency: Adults who have serious health conditions that are not life-threatening and do not require emergency room care can receive care through some free clinics that do not ask about immigration status or require insurance. In California, all children whose families meet certain income criteria are eligible for Medi-Cal without documented status requirements. Some organizations also give medication discounts. For more information, call us at  805-781-4838 (Se habla Espanol) or contact us by email. Phone interpretation services are also available.

Medi-Cal now has expanded their Denti-Cal program with new services that were not available previously. When you apply for medical insurance or check "Shop and Compare" through Covered California, you will also be offered information about dental coverage. See Covered California Dental Plans, for more details. You can also call our office at 805-781-4815, or contact us by email. 

All health plans have participating providers, but not all health care providers in the County are included in every plan. For the lowest costs, be sure that the doctor or clinic you plan to see accepts your health plan.

By phone --  You can call the “Member Services” number on your insurance card for  a list of providers in your area. This number is usually on the back. When you call, you will usually be asked to provide your member ID and your birth date, so be sure to have that information ready when you locate the phone number to your plan.

Online -- You may also find this information on the health plan’s website. On the plan’s website, you may find a “Find a Doctor” tab that allows you to search all their network providers.

Always verify with your provider’s billing department to be sure, as contracts change or expire frequently.

If you have trouble, our Health Care Navigator can also assist you with this. Call us at 805-781-4815 or contact us by email to get started.