In eligible California locations, Golden State residents and small businesses can shop for health insurance providers. Covered California provides state health care management and assistance, including online health marketplaces like the ACA Health Insurance Marketplace. The types of health insurance offered to adults and children are:
- Health insurance
- Medi-Cal, for low-income Californians
- Dental insurance coverage
- field of view
Learn more about how Covered California works, including enrollment periods, discounts, eligibility, and penalties.
Important points
- Covered California is a marketplace where Californians can purchase health, vision, and dental insurance and qualify for Medi-Cal.
- By purchasing through Covered California, many members receive beneficial insurance discounts, including reduced premiums.
- Open enrollment runs from November 1st to January 31st, but special enrollment periods may apply due to many life circumstances.
- Covered California plans are similar to ACA plans, but several different plans are offered.
California coverage structure
Covered California offers plans from all of the top health insurance companies operating in the state. Federal law requires California covered plans to provide essential health benefits. These plans are the same as those available outside the Marketplace.
“Some Californians mistakenly believe that Covered California is ‘government insurance’ or that they will receive a lower-quality health plan. That’s completely false,” said Craig Tomiyoshi, Covered California’s deputy director of communications.
Admission period
Any California resident may enroll in Covered California from November 1st to January 31st of each year. However, the interview will not start immediately. Once you select a plan, your plan will start on the 1st of the following month.
In addition to the open enrollment period, Covered California offers a very comprehensive list of over 20 life events that may qualify for the special enrollment period.
- administrative:The application has not been completed due to time constraints. Incorrect information from agents.
- Economic: Income less than 150% of the federal poverty level. I paid taxes because I didn’t have health insurance. Those who are newly eligible for health insurance.
- Emergency: Affected by a public health emergency, wildfire, or other public emergency.
- life event: Have children, adopt children, or foster children. Are married or in a domestic partnership. I have lost or will soon lose my health insurance.
- position: If you move permanently to or within California. obtained citizenship. Returned from active duty.
Unfortunately, you won’t be covered until your employer-sponsored plan expires. If you suddenly lose your job or lose benefits, there can be a gap between when you sign up for Covered California insurance and when your coverage begins. If so, consider COBRA coverage for her post-retirement, if her employer offers COBRA coverage for her.
discount
For many uninsured Californians, cost is the main reason they don’t have insurance, Tomiyoshi said. Covered California is now in its 11th year, and significant changes have been made to make the program more affordable, he said.
“More financial assistance is now available to help more Californians afford health insurance than ever before,” he said. “The increased federal aid provided by the Inflation Control Act, combined with California’s new cost-sharing reduction program, will reduce out-of-pocket costs for many eligible members in California.”
Almost 90% of Covered California enrollees receive financial assistance. Covered California allows applicants to qualify for assistance paying for health insurance and enrolling in Medi-Cal, California’s version of Medicaid.
Discount includes:
- premium tax credit: Lower your monthly premium costs or provide a tax credit when you file your taxes. Approximately 20% of enrollees benefit from $0 premiums.
- Reducing cost burden: If you earn less than 250% of the federal poverty level, your deductibles, copayments, and coinsurance will be reduced. Federal poverty levels vary by household size and income. More than 650,000 subscribers qualify for unique plans with these discounts.
California subsidies begin in 2024 with incomes up to $33,975 per person, or $69,375 for a family of four.
Penalties
Although health insurance is not required at the federal level, California requires state residents to purchase health insurance. If you don’t, you could end up paying hefty penalties when you file your state tax return. The 2024 fine is $900 for each adult and $450 for each of her dependents under the age of 18 living in the household.
Covered California offers tax penalty relief, but only in limited circumstances.
- hardship: Bankruptcy, natural disaster, eviction, and other living situations.
- Affordability predicament: The lowest-cost plan available will cost you more than 8.17% of your 2023 household income.
- religious conscience: Your faith does not permit acceptance of medical cures or public health benefits.
You may also be able to claim some exemptions when filing your state tax return.
Types of California plans covered
Like other ACA plans, Covered California plans may be offered as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and exclusive provider organizations (EPOs). Covered California offers plans from 12 companies. Although not all plans are available in all regions, 92% of Californians have four or more carriers to choose from.
Also, like ACA plans, Covered California health insurance plans have four tiers. However, there are some differences, especially when it comes to cost reduction plans.
| bronze | Silver | Money | platinum | |
| kinds | Standard and high deductibles | Standard and Extended Silver Cost Sharing Reduction | standard | standard |
| Insurance fee | lowest | lower | taller than | the best |
| out of your own pocket | the best | the best | lower | lowest |
| coverage percentage | 60% | 70% to 94% coverage | 80% | 90% |
High deductible bronze plan
High-deductible bronze plans allow participants to open a health savings account (HSA). This plan is suitable for people who want to save money in a tax-advantaged account and want to reduce their use of non-preventive medical services.
Silver reinforcement cost reduction plan
These California-only plans offer more benefits, including lower out-of-pocket costs and $0 deductibles. Available only to households below her 250% of the federal poverty level.
catastrophic plan
Minimum coverage plans (also known as catastrophe plans) are typically only available to people under 30 years of age. However, Covered California only sells these plans to adults under the age of 30.
Adults age 30 and older must apply for an affordability exemption or a general hardship exemption. Apply for a General Hardship Waiver through Covered California to obtain approval and an Exemption Certificate Number (ECN). Next, purchase a disaster plan directly from your insurance company.
“Covered California encourages consumers interested in catastrophic plans to consider bronze plans instead,” Tomiyoshi said. “Premiums are often similar, and bronze plans typically have lower deductibles. Bronze plans are available to everyone without the need for a deductible.”
Covered California Requirements
All U.S. citizens, U.S. nationals, and non-citizens residing in California, if lawfully present, may apply for health insurance through Covered California. However, if you are not legally present in California, you can use CoveredCA.com to see if you qualify for Medi-Cal.
As of January 1, 2024, California adults between the ages of 26 and 49 are eligible for Medi-Cal, regardless of their immigration status.
If you have Medicare, you cannot purchase a plan through Covered California. You also cannot purchase Medicare Advantage plans or Medicare Supplement plans through Covered California.
California history covered
In 2010, the federal Patient Protection and Affordable Care Act (ACA), also known as “Obamacare,” created a series of health care protections and rights, including the ability for states to create their own health insurance markets. California established Covered California, becoming the first state in the nation to offer its own health insurance marketplace.
Covered California appears to have been a success. According to data released at the end of 2023, the number of people who were uninsured for more than a year decreased from about 13% in 2015 to 4.5% in 2022.
How to get coverage in California
You can compare plans and insurance prices and buy online. CoveredCA.com. Alternatively, you can receive assistance from a licensed insurance agent or certified registered counselor directly or by calling 800-300-1506.
The online application process takes approximately 1 hour. You can pay online after choosing a plan or have your insurance company bill you after receiving your application. Your insurance card will be mailed to you.
Note
If you qualify for Medi-Cal but apply through Covered California, your information will be sent to your local county office for registration.
When will eligible California open enrollment take place?
Open enrollment for Covered California will be open from November 1st to January 31st. If you miss this period and experience a significant life event, such as marriage, unemployment, or adoption, you may qualify for special enrollment.
What is the difference between Medi-Cal and Covered California?
Medi-Cal provides free or low-cost health insurance to low-income Californians, including those who do not legally reside in California. California’s version of Medicaid. Eligible California states may offer financial assistance through tax credits and other out-of-pocket cost assistance to help pay your premiums. However, you must be a legal resident to sign up for Covered California.
What is the minimum income for eligible California in 2024?
There are no minimum or maximum income requirements to enroll in a Covered California plan. Eligibility for federal aid under the Affordable Care Act is based on the federal poverty level. People with incomes below 138% FPL are eligible for California’s Medi-Cal.
conclusion
Applying for health insurance through Covered California provides affordable coverage for you and your family. This health insurance protects individuals from financial crisis due to unexpected medical expenses.
California insurance plans also provide preventive care to keep you and your family healthy now and in the future. Explore your options to find a plan that fits your budget and lifestyle, and benefit from insurance discounts that may apply if you qualify.
