Tsab Cai Saib Xyuas Txaus (Affordable Care Act (ACA)) (kuj tseem hu tias Obamacare) tau ua rau muaj cov neeg coob ntxiv tau txais Medicaid (Medi-Cal hauv California).  “Adult Expansion Medi-Cal” lossis Medi-Cal rau “cov neeg loj tsis muaj menyuam” yog ib feem uas niaj hnub no tau hu tias “MAGI” Medi-Cal raws li ACA.  “MAGI” Medi-Cal txhais tau tias yog ib qho Medi-Cal qhov kev pab uas siv MAGI (hloov kho tshiab cov nyiaj khwv tau los tag nrho) rau txiav txim siab qhov muaj cai tau txais nyiaj pab rau Medi-Cal.

Leej Twg Thiaj Muaj Cai Tau Txais Adult Expansion Medi-Cal?

Koj tuaj yeem tau txais Medi-Cal raws li qhov kev pab Adult Expansion Medi-Cal tshiab yog tias:

• Koj muaj hnub nyoog li ntawm 19 thiab 64;
• Koj li MAGI nyiaj khwv tau los qis dua 138% tsoomfwv theem neeg txom nyem (FPL);1
• Koj tsis yog pojniam cev xeeb tub;
• Koj tsis tau txais Medicare;
• Koj tsis muaj Medi-Cal thaum uas twb muaj Kev Pab Them Nqi lawm.

Kuv yuav paub tau li cas tias kuv li MAGI nyiaj khwv tau los nyob hauv qab 138%?2

Koj tsis tas yuav tsum laij nws ntawm koj tus kheej.  Koj tuaj yeem sau ib “tsab ntawv thov kev hloov kho ib leeg” rau MAGI Medi-Cal hla Covered California, lub chaw haujlwm Medi-Cal hauv nroog, lossis tus lej ntawm lwm qhov chaw.   Koj tuaj yeem sau tsab ntawv thov kev hloov kho ib leeg hauv online ntawm Covered California tus website.  Yog tias koj sau thov cov nyiaj pab ntawm Medi-Cal hauv lub nroog tus website, nws yuav hloov koj txoj kev mus rau Covered California tus website yog li koj tuaj yeem thov MAGI Medi-Cal. 

Puas muaj cov cai ntsig txog cov nyiaj lossis cov khoom siv npaum cas Kuv tuaj yeem muaj thiab tseem tau txais Adult Expansion Medi-Cal?

Yog, tab sis lawv muaj qhov sib txawv los ntawm pre- ACA Medi-Cal.  Pre-ACA Medi-Cal muaj qhov txwv nruj heev txog cov nyiaj khwv tau los npaum li cas thiab cov khoom vaj tse npaum li cas uas koj tuaj yeem muaj.  MAGI Medi-Cal siv txoj hauv kev sib txawv los laij cov nyiaj khwv tau los, thiab tso cai ib tus neeg kom muaj ntau txog $16,242 lub xyoo ntawmMAGI cov nyiaj khwv tau los.  Ntawv yog 138% ntawm tsoomfwv theem neeg txom nyem.  Txawm li cas los xij, raws li MAGI Medi-Cal, tsis muaj cov nyiaj khwv tau los uas tseem tsis tau suav lossis txiav tawm dhau ntawm qee cov kev txiav tawm tau siv los txiav txim pob nyiaj ntawm koj li MAGI.  Thiab, tsis zoo li pre-ACA Medi-Cal tsis muaj kev ntsuas khoom siv rau MAGI Medi-Cal.3 Qhov no txhais tau tias koj tuaj yeem muaj ntau dua $2,000 toj ib tus neeg/3,000 toj ib nkawm niam txiv txwv rau  pre-ACA Medi-Cal.4

Yuav Ua Cas yog tias Kuv muaj Medi-Cal Sib Pab Them Lawm?  Puas Yog kuv tuaj yeem hloov mus rau Adult Expansion Medi-Cal?

Yog.  Koj tuaj yeem tiv toj koj lub Chaw Haujlwm Medi-Cal Hauv Nroog thiab nug lawv kom tshuaj xyuas seb tam sim no koj puas muaj cai tau txais MAGI Medi-Cal nrog tsis muaj sib pab them.  Lub nroog kuj yuav tshuaj xyuas yog tias koj muaj cai rau MAGI Medi-Cal ntawm koj qhov rov txiav txim siab hauv ib lub xyoos.  Lub nroog yuav muab MAGI Medi-Cal rau koj yog tias koj muaj cai tau txais nws.

Yam Kev Pab Twg Kuv tuaj yeem Tau Txais los ntawm Adult Expansion Medi-Cal?

Koj tuaj yeem tau txais txhua yam kev pab raws li ib txwm muaj hauv Medi-Cal, suav nrog cov tsev laus, Kev Pabcuam Hauv Tsev (IHSS), thiab lwm yam kev pabcuam sijhawm ntev, yam tsis tas yuav ntsuas khoom vaj tse.5  Tsis tas li ntawv xwv, koj tuaj yeem tau txais cov kev pab siv sijhawm ntev thiab khomob hlwb los ntawm Medi-Cal qhov kev npaj tswjhwm khomob thiab los ntawm lub nroog qhov kev pab khomob hlwb/kho mob cwj pwm.6 Yog koj xav tau qhov kev pab zam rau nyob hauv tsev thiab hauv zej zog (HCBS) koj tuaj yeem thov rau pre-ACA Medi-Cal hla lub chaw haujlwm Medi-Cal hauv nroog.  Koj tuaj yeem ua li no uas yog sau daim ntawv foos7  SAWS 2 Plus.

Muaj Qhov Chaw Pabcuam Twg Ntxiv yog tias Kuv Muaj Lus Nug Ntau Ntxiv?

Hauv qab kawg ntawm tsab ntawv no, peb tau sau cov npe chaw pabcuam hauv Internet uas yuav muaj txiaj ntsig zoo rau kev tshawb nrhiav txuas ntxiv.  Tsis tas li ntawv xwb, koj lub nroog qhov chaw haujlwm Medi-Cal, http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx, thiab Covered California, www.coveredca.com, 1-800-300-1506, tuaj yeem teb cov lus nug.

Cov koom haum txuas ntxiv no tuaj yeem pab nrog cov kev pab:

• Disability Rights California, www.disabilityrightsca.org, 1-800-776-5746, lossis
• Koj lub koom haum pabcuam kev cai lij choj hauv zej zog. Qhov Health Consumer Alliance sau cov npe koom haum no rau ntawm http://healthconsumer.org/index.php?id=partners.

• 1. Lub Chaw Haujlwm Saib Xyuas Kev Cai Lij Choj Rau Cov Neeg Laus Hauv Tebchaws tau sau ib co ntsiab lus muaj txiaj ntsig zoo txog kev nthuav dav Medicaid hauv California, uas hais txog cov nyiaj khwv tau los muaj cai.  Saib hauv http://nsclcarchives.org/wp-content/uploads/2013/11/1CA-Eligibility-Brief-4.pdf: “MAGI cov qauv laij tsis suav qee cov nyiaj khwv tau los nyob rau hauv, piv txwv li, Qub tub rog cov nyiaj pab, cov nyiaj tau txais los ntawm kev pab menyuam, thiab cov nyiaj pab nqi kawm, cov nyiaj pab dawb, thiab khoom plig siv rau lub hom phiaj kev kawm. Expansion Medi-Cal kuj yuav tso cai rau txiav tawm lwm cov nyiaj khwv tau los uas tsis tau tso cai raws li Medi-Cal qhov ib txwm suav nyiaj khwv tau los, suav nrog piv txwv li, nyiaj them yug pojniam nrauj lawm thiab nyiaj npaj pab them se rau cov kev siv nyiaj xws li nyiaj tus menyuam lossis nyiaj laus (txawm tias, qhov rov qab qees, nws yuav  tsis tso cai qhov A&D FPL txiav tawm rau cov nqi them pab kas phais khomob.”   Lub U.C. Chaw Haujlwm Saib Xyuas Dag Zog Berkerley muaj ib-nplooj ntawv sau nrog cov lus piav qhia yooj yim txog yuav laij cov MAGI li cas.  Nws muaj nyob rau ntawm no:  http://laborcenter.berkeley.edu/healthcare/MAGI_summary13.pdf. “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”
• 2. Kom paub ntau ntxiv txog MAGI, saib Txoj Haujlwm Tsab Kev Cai Lij Choj Saib Xyuas Kev Noj Qab Haus Huv Hauv Tebchaws “Phau Ntawv Qhia Kev Pabcuam rau MAGI,” muaj nyob ntawm  http://www.healthlaw.org/publications/agmagi “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”
• 3. Pre-ACA Medi-Cal nug txog cov ntaub ntawv ntsig txog koj cov khoom vaj tse, thiab yog tias koj muaj ntau dhau, koj yuav tsis muaj cai tau txais Medi-Cal.  Raws li MAGI Medi-Cal koj tsis raug hais kom ntsuas cov khoom vaj tse no. “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”
• 4. http://nsclcarchives.org/wp-content/uploads/2013/11/1CA-Eligibility-Brief-4.pdf “ Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”   
• 5. California tau ceebtoom cov nroog uas muaj MAGI cov neeg laus xav tau kev pabcuam nyob hauv tsev laus tuaj yeem tau txais cov kev pab no raws MAGI qhov muaj cai yam tsis muaj qhov ntsuas cov khoom vaj tse: http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/MEDIL2014/MEDILI14-06.pdf. California kuj tseem tau ceebtoom rau cov nroog uas muaj MAGI cov neeg laus uas muaj cai rau cov kev pab LTSS hauv zej zog ib yam nkaus:  http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/MEDIL2014/MEDILI14-11.pdf.  Txawm tias tsis muaj qhov txiav txim txog kev xiam oos qhab rau MAGI Medi-Cal los xij, koj yuav tsum ua tau raws li cov qauv kev khomob tsim nyog rau LTSS cov kev pab. “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”
• 6. Saib hauv, http://www.dhcs.ca.gov/formsandpubs/laws/Documents/Pending%20SPA%2013-038%20not%20ADA.pdf; http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2013/APL13-021.pdf. “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”
• 7. http://www.cdss.ca.gov/cdssweb/entres/forms/English/SAWS2PLUS.pdf  “Rov Qab mus rau Cov Ntaub Ntawv Tseem Ceeb”