Mr. Samy Beshay writes: Obama Care

Mr. Samy Beshay Expert in all types of insurance

Obama Care

      The family can obtain low-cost health insurance with monthly financial assistance to help them pay premiums.

The monthly premium that the insured pays in return for obtaining the medical service through the health insurance company. The insured pays the monthly premium whether he uses insurance or not. The cost of health insurance is affected according to the family's annual income and according to how many family members and also according to the place of residence and the cost of insurance is not affected by the situation The health of the insured or whether he is a smoker or not.


It is a sum of money that the insured pays when using it for medical services, such as visiting a doctor, conducting medical tests, x-rays, or performing medical surgeries.

For example, if the cost of a visit to the doctor is $200, the insured pays $40, and the health insurance company pays $160.


It is a specific amount that the insured must pay within a year from the start of the health insurance towards the medical bills before the health insurance company begins to pay the cost of the medical service obtained by the insured. For example, if the insurance plan includes a Deductible of $2,500, the insured pays part of the Deductible in Hospital Stay, Emergency Room, and Ambulance.

For example, if the insured pays the Deductible amount within seven months, he is not required to pay any deductible until the end of the year from the beginning of his insurance.

Some insurance plans do not have Deductible, such as the Gold & Platinum insurance plan.

Maximum out Of Pocket

It means the maximum amount that the insured pays from his pocket within a year from the beginning of the health insurance in return for benefiting from the medical services covered in the health insurance policy.

The Maximum Out Of Pocket from one insurance plan amount varies to another.

Usually, the family has twice the number of one person.

If the insured spends the maximum amount out of pocket within a few months, the health insurance company will pay the entire amount during the rest of the year from the beginning of the health insurance.

      There is a range of options for quality health insurance plans with four levels of coverage, represented in:


  - Bronze level and covers about 60% of the covered health expenses.

  - Silver level and covers about 70% of the covered health expenses.

  - Gold level and covers about 80% of covered health expenses.

  - Platinum level and covers about 90% of covered health expenses.


* Documents required to obtain Medi Cal or Covered CA. :

  Proof of current income.

  - Driver's license or ID card issued by the state of California.

  There is evidence of legal residencies, such as a US passport, a US citizenship certificate, or a green card.

  Date of birth, residential address, and social security number.


* There are some cases in which the owners can apply within 60 days of the event, such as:

  Marriage status.

  That the family had a new baby.

  Loss of health coverage granted by the employer.

  He was changing his permanent residence to another state.

  - Obtaining a new legal residence.

  Loss of medical

* Health insurance companies offer three types of insurance plans:


  The first plan, HMO: You choose a doctor and a hospital that is included in the health plan network.

A letter from a primary care physician to be able to visit a specialist.

  - The second plan, PPO: Means that you can visit a doctor from within or outside the plan's network without the need for a referral.


  - The third plan is EPO: It means that you can visit a specialist doctor from within the plan's network without the need for a referral.


      One of the advantages of the law is that it allows obtaining health insurance without asking about the pre-existing condition or health history. The health insurance company cannot refuse to sell health insurance to anyone, regardless of their health condition.

      This law also unified the insurance plans in Copay, Deductible, Maximum out of pocket, making it easier to choose the appropriate insurance plan.


    This law also contributed to solving a problem that some families were suffering from, which is the family's fear of losing medical care in an increase in income. Now every family can obtain monthly support to help get health insurance at an affordable cost.


Note, dear reader, that Obamacare is still in effect to this day, and we will update you with any changes or amendments to the law.

I welcome all your questions to the following email:


With my heartfelt wishes for you, dear reader, good health and wellness...

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