Covered California offers state healthcare administration and assistance, including an online health marketplace like a data-component=”link” data-ordinal=”1″ data source=”inlineLink” Covered California provides state healthcare administration, assistance and an online marketplace similar to ACA Health Insurance Marketplace. There are several types of health insurance for both adults and children.
- Health Insurance
- Medi-Cal for Californians with Low Income
- Dental coverage
- Vision coverage
Learn about Covered California, including the enrollment period, discounts, qualification, and penalties.
Takeaways from the Key Notes
- Covered California allows Californians to buy health, vision and dental insurance or qualify for Medi-Cal.
- Many enrollees can receive discounts, such as reduced insurance premiums, by purchasing through Covered California.
- Open enrollment runs from Nov. 1 to Jan. 31. However, certain life circumstances could qualify you for an extended enrollment period.
- Covered California offers a number of plans that are similar to ACA.
Covered California: How Does It Work?
Covered California provides plans from the leading health insurers in California. Covered California must comply with federal law and provide essential health benefits. These plans are identical to the plans offered outside the marketplace.
Covered California’s deputy director of communication, Craig Tomiyoshi said that some Californians believe Covered California to be ‘government health insurance’, or that they will receive a less comprehensive plan. This is false.
Small Businesses may apply for health and dental plans for their employees via the covered California for small businesses marketplace.
Enrollment Periods
Covered California is open to all Californians between November 1 and January 31 of each year. However, coverage doesn’t start right away. The plan you select will begin on the 1st of the month following your selection.
Covered California provides a comprehensive list of over two dozen life events which could qualify you for an special period. These include: 1
- Administrative : Incomplete applications due to lack of time; incorrect information from a representative.
- Economic : Income below 150% of federal poverty level, paid tax penalty for not having health insurance.
- Emergencies : Affected by a public health emergency, wildfires, or other public state of emergencies.
- Life Event Had, adopted or fostered a baby; got married, or in a domestic partner; lost, or will soon be losing health insurance.
- Location : Moved permanently to California or within California, gained citizenship, returned from active duty service.
Unfortunately, coverage is not available until the employer-sponsored insurance plan ends. You may have to wait a while before Covered California coverage starts if you lose your job or benefits suddenly. If this is the case, you may want to consider COBRA after termination from your employer if they offer it.
Discounts
Tomiyoshi stated that many Californians are not insured because they cannot afford it. Covered California has been undergoing substantial changes in the eleventh year of its existence to make it more affordable.
He said that more financial assistance is now available to Californians in order to help them obtain health insurance. The Inflation Reduction Act, combined with California’s Cost-Sharing Reduction Program will reduce the out-of-pocket expenses for many Covered California Members.
Nearly 90% of Covered California enrollees receive financial assistance. Covered California offers applicants the opportunity to receive financial assistance for enrolling in Medi-Cal or health plans.
Included in the discount:
- Premium Tax Credit Lowers the monthly premium or offers tax credit for filing taxes. Approximately 20% of enrollees receive $0 in premiums.
- Cost sharing reductions Reduces your copays and coinsurance, if you earn less than 250% of the Federal poverty level. The federal poverty line is determined by your household income and size. These reductions are available to more than 650,000 people.
In 2024, the covered California subsidy kicks in when a person earns up to $33,975 and a family can earn up to $69375.
Penalties
California residents are required to carry health insurance, even though health insurance at the federal level is not mandatory. If they don’t, they could be hit with a heavy penalty when filing their state tax returns. The penalty for 2024 is $900 for each adult and $450 for each dependent child below 18 who lives in the household. 6
Covered California provides tax penalty exemptions in certain situations, but only for a limited number of people: 7
- Hardship : A bankruptcy, a natural disaster, an eviction or other circumstances.
- Affordability difficulties : The lowest priced plan costs more than 8.17 percent of your household income in 2023. 9
Covered California. ” Hardship Exemption.”
- Religious conscience : Your religion does not allow you to accept medical treatment or public health benefits.
When you file your state’s tax return, you may be able claim certain exemptions.
California Covered Plans Types
Covered California plans are available in health management organizations (HMOs), preferred providers organizations (PPOs), and exclusively provider organizations. Covered California has plans from 12 different companies. Covered California offers plans from 12 companies.
Covered California plans are also available in four tiers. There are some differences in the cost-sharing plans, especially around 13.
| Bronze | Silver | Gold | Platinum | |
| Types | Standard and High Deductible | Cost sharing reductions for Silver Standard and Enhanced | Standard | Standard |
| Premiums | Lowest Price | Lower Prices | Higher | Highest |
| Out-of-Pocket | Highest | Highest | Lower Prices | Lowest Price |
| Percentage Coverage | 60% | Coverage ranges from 70% to 94% | 80% | 90% |
High-Deductible Bronze Plans
The High-Deductible Bronze Plans offer the option to open a Health Savings Account (HSA). These plans are ideal for people who wish to invest in a tax-advantaged plan and believe they will use less non-preventive health care. 14
Silver Cost Sharing Reduction Plans
These California-only insurance plans provide more coverage for less money out of pocket, with $0 deductibles. These plans are only available to those households that fall below or equal to 250% of the federal poverty level. 15
Catastrophic Plans
Minimum coverage plans (also called catastrophic plans) are typically available only to people under 30. Covered California sells only these plans to adults younger than 30. 16
Adults aged 30 or older can apply for a general hardship exemption. Covered CA will approve your application for a hardship exemption and issue you an Exemption Certificate Number. You then purchase a catastrophic insurance plan directly from the insurer.
Tomiyoshi stated that “Covered California encourages customers interested in a catastrophic policy to consider a Bronze Plan instead.” The premiums and deductibles of Bronze plans are similar. Bronze plans are open to all without an exemption.”
California Covered California Requirements
If you are legally present in California, all U.S. Citizens, U.S. Nationals, and Noncitizens can apply for medical care through Covered California. CoveredCA.com can help you determine if Medi-Cal is available to you if you are not legally present in California.
If you have Medicare, you cannot purchase a Covered California plan. Covered California does not sell Medicare supplement or Medicare advantage plans.
History of Covered California
In 2010, the federal Patients Protection and Affordable Health Care Act (ACA), also known as “Obamacare,” created a number of health care rights and protections, including the right for states to establish their own marketplaces for health insurance. California became the first state in the country to create its own health insurance market, Covered California.
Covered California is a successful program. According to data released late in 2023, the number of people who had been uninsured for at least a year dropped from 13% to 4.5% by 2022.
California Coverage: How to get covered
Compare plans and pricing then purchase online at CoveredCA.com. You can also get assistance from an insurance agent or enrollment counselor by visiting them in person, or calling 800-300-1506.
It takes around an hour to complete the online application. After selecting a plan you can pay online or the insurer will bill you after receiving your application. You will receive your insurance card by mail.
Note:
Your information will be sent directly to the county office for enrollment if you apply for Medi-Cal through Covered California.
What is covered by California Open Enrollment coverage?
Covered California’s open enrollment period runs from November 1 to January 31. If you miss the open enrollment period, but experience a major qualifying event, such as marriage, job loss or adoption, then you may qualify for a special enrollment.
What is the difference between Medi-Cal and Covered CA?
Medi-Cal provides low-income Californians–including those not in California legally–free or low-cost healthcare coverage. California’s Medicaid. Covered California offers financial assistance through tax credit for your premiums and other out-of pocket costs. Covered California is only available to legal residents.
What is the minimum income for covered California in 2024?
Covered California does not have a minimum or maximum required income to enroll. The Federal Poverty Level determines eligibility for federal subsidies under the Affordable Care Act. Medi-Cal is available in California to those with incomes below 138% of the FPL.
Bottom Line
Covered California offers affordable health insurance for you and your family. This health insurance covers you against a financial crisis due to unexpected medical expenses.
California’s covered insurance plans offer preventive health care, so you and your family can stay healthy today and in the future. Explore your options and find a plan to fit your lifestyle, budget, and needs. You can also benefit from insurance discounts if you are eligible.
Article SOURCES
Investopedia’s writers are required to use primary resources to support their writing. White papers, government statistics, original reporting and interviews with experts in the industry are some of these sources. Where appropriate, we also refer to original research by other reputable publishers. Our editorial policies will tell you more about our standards for producing accurate and unbiased content.
- Covered California. Deadlines and Dates.
- Covered California. ” When will my coverage begin?
- Covered California. ” Qualifying life events.”
- Covered California. ” Covered California“
- Covered California. ” Covered California Health Plans and Rates.”
- Covered California. “Penalty.”
- Covered California. “Exemptions.”
- Covered California. General Hardship Excemption.
- Covered California. ” Hardship Exemption for Affordability.”
- Covered California. ” Religious Conscience Excemption.”
- Covered California. “Get Started.”
- Covered California. ” Covered California plans and rates for 2024.”
- Covered California “2024 Patient Centered Benefit Designs.”
- Covered California. “Covered California Bronze.”
- Covered California. Covered California launches state-enhanced cost-sharing reduction program .
- Covered California. “Minimum Coverage Plans.”
- Covered California. “Information for Immigrants.”
- Covered California. Covered California.
- Covered California “Program Eligibility based on Federal Poverty Level by 2024.”
