There’s a lot more to the Affordable Care Act than buying private health insurance through an exchange marketplace like http://www.CoveredCA.com.
Four kinds of public benefits can help people get the medical care they need:
- Subsidized premiums and co-pays for private health insurance purchased through an exchange. Commercial insurers issue these policies, not the government.
- Medicare, for people who have contributed the necessary number of quarters during their years of employment. Medicare Set-Asides are required when a Medicare beneficiary settles a claim for future medical care.
- Expanded Medi-Cal for people with low income; there is no asset limit, no requirement for a set-aside
- Traditional Medi-Cal for the indigent; there are income and asset limits, no requirement for a set-aside
These types of benefits are frequently confused, especially because the names are so similar. For optimal settlement of a Workers Compensation case, you need to know the injured worker’s eligibility for these plans.