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Covered California is the state’s health insurance marketplace where individuals and small businesses can shop for health insurance – online, in person or by phone. Here they can explore and compare Covered California plans to find what’s best for their needs and budget.
Individuals can also learn if they qualify for low cost or free health insurance and receive federal financial assistance. In addition, they can find out if they qualify for public health insurance programs like Medi-Cal. When you complete a Covered California application, your application will be automatically reviewed for Medi-Cal eligibility.
Covered California is the only place where you can apply for federal financial assistance to help reduce your health care costs.
Who Can Use Covered California To Buy Insurance?
Legal residents of California may be eligible to buy government health insurance coverage through Covered California. Individuals must present proof they are “lawfully present” in the U.S. to be eligible for insurance.
Who is considered “lawfully present”?
A lawfully present person in the United States falls under these categories:
- A U.S. national or U.S. citizen.
- A lawful permanent resident (or “green card holders”).
- A lawful temporary resident.
- Persons escaping oppression, including refugees and asylees.
- Other humanitarian refugees, including those under the safeguard of temporary protected status.
In addition, employers with less than 25 full-time workers can apply for Covered California and learn if they qualify for a small business tax credit to assist with the cost of providing health insurance to their employees.
When Can You Buy Coverage Through Covered California?
You can sign up for Covered California when open enrollment begins on November 15, 2014; it continues through February 15, 2015.
Covered California also has a special-enrollment option for individuals who undergo what’s defined as a “qualifying life event” and have to enroll outside of open enrollment. This includes:
- Getting married
- Having a child
- Loss of health coverage
- Change in income
- Change in lawfully present status
Medi-Cal enrollment for those with qualifying incomes is available throughout the year.
Type of Health Insurance Offered Through Covered California?**
Covered California offers a range of plans so you can choose the one that best meets your financial situation and health needs.
The health plan category you choose determines how you and your plan share the costs of care.
There are 5 categories, identified as “metal levels” of coverage under Covered California plans. Plans in each category pay different amounts of the total costs of an average person’s care. The actual percentage you’ll pay in total or per service received is related to the services you access during the year.
- Bronze: On average, this health plan pays 60%. You pay approximately 40%.
- Silver: On average, this health plan pays 70% on average. You pay approximately 30%.
- Gold: On average, this health plan pays 80% on average. You pay approximately 20%.
- Platinum: On average, this health plan pays 90% on average. You pay approximately 10%.
- Catastrophic: On average, catastrophic coverage plans pay less than 60% of the total average cost of care. They’re available only to people who are under 30 years old or have a hardship exemption.
Under Covered California, dental coverage for children (someone 18 or
younger) is an essential health benefit – you are required to have dental
coverage for all children. Dental coverage is available as part of a health plan or
as a stand-alone plan.