Balboa United’s
Coverage Education & Resources (CovER)
Department
Our Mission is to help you understand your benefits, options, rights, and responsibilities so you never find yourself without proper and affordable access to medical care.
The Coverage Education & Resources Department (CovER) is not a group of agents or brokers and is a free service available to all Balboa Nephrology patients and works in tandem with Balboa Staff and Physicians. We work hard so you can remain focused on what is truly important, your health and well-being.
CovER Initiative
Coverage, Education & Resources
ARE YOU:
Uninsured or underinsured?
ARE YOUR:
Co-payments, co-insurances, deductibles, or premiums too high?
DO YOU HAVE QUESTIONS ABOUT YOUR:
Benefits, Options, Rights and/or Responsibilities?
WANT TO FIND OUT IF YOU QUALIFY FOR:
- Medi-Cal
- Medicare
- Affordable Care Act (ACA, CoveredCA, “Obamacare”)
- Medicare Advantage (Part C) Medigap policies?
For unbiased assistance or an in-person consultation contact:
Iniciativa de CobERtura
Cobertura, Educacíon & Recursos
¿TE ENCUENTRAS:
Sin seguro medico o con seguro medico insuficiente?
¿ESTAN TUS:
Co-pagos, co-seguros, deducibles, primas demasiados altos?
¿TIENE PREGUNTAS SOBRE SUS:
Beneficios, Opciones, Derechos y/o Responsabilidades?
¿QUIERE SABER SI PUEDE CALIFICAR PARA:
- Medi-Cal
- Medicare
- Affordable Care Act (ACA, CoveredCA, “Obamacare”)
- Medicare Advantage (Parte C) Medigap política suplementaria?
Para asistencia imparcial o una consulta en persona, contacto:
CovER@balboaunited.org
Lost your Medi-Cal coverage? Don’t worry, Balboa United’s CovER Dept is here to help!
We know things can get confusing when it comes to health insurance, especially if you’ve lost your Medi-Cal coverage due to recent changes or other reasons. But you don’t have to go through this alone!
The CovER Dept has experts who can help you find the best health insurance option for your needs. We’ll consider your:
- Medical needs and goals: Whether you need specialized care for kidney health or other conditions, we’ll find a plan that covers what’s important to you.
- Medication costs: We’ll compare plans to find one that helps you afford your essential medications.
- Network of doctors and hospitals: We’ll make sure you have access to the healthcare providers you trust.
Here’s how we can help:
- Screen you for different health insurance plans: We’ll compare plans from different providers and explain the pros and cons of each one.
- Help you understand your options: We’ll break down the plan details in plain language so you can make an informed decision.
- Connect you with resources: We can point you to programs and services that can help you pay for your healthcare needs.
Please don’t hesitate to contact Balboa United’s CovER Dept if you have any questions. Remember, you have the right to quality healthcare, and we’re here to help you find it.
We’re Patient Advocates ready to help navigate healthcare hurdles!
Prescription Woes?
We understand that this can be frustrating, especially if you need your medication right away. We can help you figure out why your prescription is having trouble being filled and work with your doctor and pharmacist to resolve the issue.
Waiting Blues
We know that waiting for approval for the care you need can be stressful. We can help you understand the process and advocate on your behalf to get your prior authorizations and referrals approved as quickly as possible.
Bill Shock
We can help you review your medical bills and understand what you are responsible for paying. We can also help you negotiate with your insurance company or healthcare provider to get your bills reduced or waived, if necessary.
What you can expect from the Balboa United CovER Dept:
- Unbiased guidance: We’ll help you find the best healthcare plan for your needs, considering medication costs, medical bills, your preferred doctors, and your health goals. No pushing products, just honest advice.
- Application experts: Whether it’s Covered CA, Medi-Cal, or enrolling in Medicare, we’ll walk you through the entire process, handle the paperwork, and make sure you get the coverage you deserve.
- Food assistance support: Need help accessing CalFresh (Food Stamps) or other food programs? We’ll connect you with the resources you need to put food on the table.
- Upgrade your insurance: Don’t settle for subpar coverage. We’ll explore options for obtaining better insurance or maximizing your existing plan.
- Disability program navigation: Confused about SSI, SDI, or SSDI? We’ll demystify the process and help you apply for the benefits you may be eligible for.
- Easing the financial burden: We’ll connect you with medication assistance programs to take the sting out of medical bills.
- Getting you where you need to go: Need help finding reliable non-emergency medical transportation or non-medical transportation? We can help arrange rides to doctor’s appointments and other essential destinations.
- Connecting you to a network of resources: We’ll point you towards valuable community, county, state, and federal programs that can support your overall well-being.
Major Change for California Medi-Cal Recipients
As of January 1st, 2024, a major change has taken place for Medi-Cal recipients in California. If you were previously on Emergency Medi-Cal, you’ve officially transitioned to Full-Scope Medi-Cal, meaning you’ll have access to a wider range of healthcare services.
What’s the difference? In the past, Emergency Medi-Cal only covered urgent situations, like ER visits, hospital stays, and life-threatening conditions. While crucial for emergencies, it didn’t cover other important healthcare needs.
Now, with Full-Scope Medi-Cal, you can get the care you need for everyday health issues, completely free. This includes things like:
- Prescription medications: No more worrying about the cost of essential medicines.
- Chronic disease care: Get the treatment you need for conditions like diabetes and heart disease.
- Durable medical equipment: If you need a wheelchair, walker, or other equipment to stay healthy, it’s covered.
- Mental health services: Access therapy, counseling, and other mental health support.
- Dental and vision care: Take care of your smile and eyesight with basic coverage.
- And more! From lab tests to non-emergency transportation, Full-Scope Medi-Cal has you covered.
This is a huge step forward for California, making it the first state to offer comprehensive healthcare to low-income undocumented immigrants. This expansion will not only improve individual health, but also reduce the financial burden on families and healthcare providers. It’s a true step towards a healthier future for all Californians.
Learn more about the Medi-Cal Expansion Program here.