Our Certified Enrollment Counselors (CECs) are responsible for facilitating access to quality health care, insurance, and education for all members of the community, especially the uninsured and under-insured.
Our CECs assess and enroll patients in various programs such as Covered California, Medi-Cal, Medicare, CMSP, Healthy Families, Healthy Kids, Partnership HealthPlan, Petaluma Health Center’s Sliding Scale program, CalFresh and others. They also connect patients with resources such as housing, transportation, food, etc.
If you don’t have insurance, you may qualify for financial assistance based on your income level. The document below outlines eligibility criteria and service rates by income and family size.
The Marketplace, also known as the Exchange is where those that are uninsured can purchase health insurance. In California, this will be run by the state’s program, Covered California, and you can sign up by phone, online, or in person. Other information regarding cost and eligibility are also available through the site https://coveredca.com.
Legal residents of California cannot be denied coverage for a pre-existing medical condition and do not need to pass a medical exam. Coverage will include preventive care, immunizations, screenings, emergency care, laboratory services, prescriptions, mental health services, maternity, newborn and pediatric care.
Petaluma Health Center offers drop-in hours and scheduled appointments to meet with a certified enrollment counselor that can assist you in choosing a plan that’s right for you. We can also help you enroll in other programs you may be eligible for.
For an appointment, call our main line (707) 559-7500.
To qualify for subsidized coverage, you must go through the Marketplace. You may qualify for financial assistance based on income requirements.
Financial assistance includes:
Adults with income up to 138 percent of the Federal Poverty Level and parents with an income between 106 percent and 138 percent of the Federal Poverty Level are eligible for Medi-Cal.
Petaluma Health Center also offers a sliding scale which patients may qualify for in addition to Medi-Cal.
Three options are available if you qualify to receive assistance to pay for your premiums:
*This option is encouraged for individuals whose income changes throughout the year.
Covered California will use the information that was shown on your most recent tax return. If there will be a drastic income change on your tax returns, you can provide Covered California with an appropriate income estimate. Covered California will compare the two incomes and if there is a discrepancy then the consumer is responsible for paying back any assistance that was given when not needed.
A person will not be required to obtain coverage if they:
However, individuals must provide documentation to meet these criteria.
Please visit https://coveredca.com/FAQs/
The costs for name-brand prescriptions will depend on the plan and tier an individual purchases.
If you have insurance through your employer, you can change your plan during the employer’s enrollment period.
If you have individual private insurance, you can cancel your insurance plan any time of the year.
If you have private insurance through Covered California, you can only change your coverage during the enrollment period or with a life changing event.
If you are a parent of a young adult, you do not have to provide insurance for your child. But, if you claim your child as a dependent on your taxes, then they will not be able to purchase their own coverage through Covered California.
Yes, but only if the married couple files their taxes separately.
