Resources for Consumers
Get help with enrollment, access to care, and complaints.
Enrollment through Covered California, The State Exchange Marketplace
Covered California is the gateway to most enrollment options, including Medi-Cal (Medicaid in California), if you do not have health benefits through your job. Even if your employer does offer health benefits, those benefits may not be affordable. You may find more affordable options through Covered California.
Most people actually need help finding the right plan. Certified Enrollment Counselors (CEC’s) and Certified Enrollment Entities (CEE’s) are individuals and organizations that are certified by Covered California to offer one-on-one enrollment assistance to help you find the right health insurance plan to fit your needs.
- Find Certified Enrollment Entities near you.
- Shop and Compare plans different health insurance plans with the Covered CA Shop and Compare tool.
- For assistance with questions or concerns regarding Covered CA call toll free: (800) 300-1506.
Medi-Cal, the Medicaid program in California, provides free or low-cost coverage to eligible low-income people. Find out if you’re eligible and apply through Covered CA (www.coveredca.com) or directly by visiting to the California Department of Health Care Services website.
DHCS (the Department of Health Care Services, which oversees Medi-Cal) also provides a hotline for members with questions, issues, or complaints: 1-800-541-5555.
California Health Advocates (www.cahealthadvocates.org) offers free individual counseling about Medi-Cal/Medicare through their Health Insurance Counseling and Advocacy Program (HICAP), with offices in every county and a toll-free hotline: 800-434-0222.
Medicare is the federal health insurance program for aged (65 or older) and certain persons with disabilities (those who are dually eligible for Medicare and Medi-Cal);
Small Business Owners
The Small Business Health Options Program (SHOP) is the health insurance marketplace in Covered California for small business owners (with one to 50 eligible employees). Visit the SHOP marketplace at http://www.coveredca.com/small-business/ to explore coverage options for employees. The Health Coverage Guide (www.healthcoverageguide.org), produced by Small Business Majority with funding from the California Healthcare Foundation, provides information small business owners need to navigate their decisions related to health insurance, including cost estimates, tax savings, coverage options, legal rights, and more.
Legal Advice or Representation
The Health Consumer Alliance (http://healthconsumer.org) has a number of brochures and resources about healthcare programs and provides legal assistance for residents of California. Contact HCA toll-free at 888-804-3536, or find the Local Center in your county here: http://healthconsumer.org/index.php?id=partners.
California Rural Legal Assistance, Inc. (www.crla.org) offers legal advice for residents in rural areas.
Help Paying Hospital Bills
The Hospital Bill Help Website (www.hospitalbillhelp.org) is an consumer information project of Health Access, ACCE, CalPIRG, Congress of California Seniors, Consumers Union, Health Consumer Alliance and Western Center on Law and Poverty (funded by Community Catalyst) built around the belief that all Californians have a fundamental right to hospital care at a fair price. Whether you are uninsured or under-insured, this is the place to learn about fair price discounts, charity care options, public policy on hospital billing, and more.
Questions or Complaints About Your Insurance Plan
- The HMO Help Center (www.healthhelp.ca.gov) at the Department of Managed Health Care and
- the Office of the Patient Advocate (http://opa.ca.gov) explain health care rights and help consumers understand how to use their healthcare benefits at: 888-466-2219.
- The Department of Managed Health Care has a comprehensive set of Resources (about managed care) for Consumers.
- The Department of Insurance (www.insurance.ca.gov) has set up a DOI consumer hotline at 800-927-HELP or (213) 897-8921, to answer questions/concerns about DOI-regulated insurance. You may also file a complaint through the DOI website under the “Health Related Insurance” tab.
Social Services (Food, housing, Jobs, health care, counseling, etc.)
- http://211.org, operated by United Ways, allows users to search by city or zip code for referrals to social services such as help with food, housing, employment, health care, counseling, and more.
- County Welfare Departments can also be found at http://www.dss.cahwnet.gov/foodstamps/PG839.htm
Health Care for Specific Populations
- Disability: Disability Rights California (www.pai-ca.org) offers patient-rights advocacy, legal advice, representation, and other services with physical, psychiatric, and developmental disabilities. Please call 800-776-5746.
- HIV/AIDS: The AIDS Legal Referral Panel (http://www.alrp.org) serves persons living with HIV disease or AIDS who reside in Bay Area counties (Alameda, Contra Costa, Marin, San Francisco, San Mateo, Solano, and Sonoma). Call (415) 701-1100 (San Francisco) or (510) 451-5353 (Oakland).
Assistance from Elected Representatives
If any of your issues or concerns are not addressed by any of the resources above, you may want to contact your elected representatives. They usually want to know if some part of federal or state law is not working the way it should--and they may be able to help.
- State Senators and Assembly members contact information (by zip code) at http://www.leginfo.ca.gov/yourleg.html or http://www.legislature.ca.gov/port-zipsearch.html
- Congressional Representatives’ office contact information can be found at http://clerk.house.gov/member_info/index.html. Casework assistance and intervention with federal agencies is available through Senator Barbara Boxer’s office by calling (415) 403-0100 or visiting http://boxer.senate.gov/en/services/assistance/index.html and from Senator Dianne Feinstein’s San Francisco office by calling (415) 393-0707.