Covered California: What It Is, Who It Helps, and When You Can Enroll
Health insurance can feel complicated, especially when your circumstances suddenly change. You may have lost employer coverage, become self-employed, turned 26 and aged off a parent’s plan, or need to purchase health insurance on your own.
For Californians, Covered California is one place to explore individual and family health insurance options and determine whether financial assistance may be available.
What Is Covered California?
Covered California is California’s health insurance marketplace established under the Affordable Care Act (ACA).
Through Covered California, eligible California residents can compare health plans offered by participating insurance companies, enroll in coverage, and find out whether they qualify for financial assistance to help reduce their health care costs.
One application can also determine whether members of your household may qualify for Medi-Cal rather than a Covered California health plan.
Who Can Apply?
Generally, you can apply for Covered California coverage if you live in California and meet applicable citizenship or lawful-presence requirements. Eligibility for financial assistance depends on factors including your household and expected annual household income.
Covered California may be an option for people who are:
Self-employed or independent contractors
Between jobs
Losing employer-sponsored health insurance
Turning 26 and leaving a parent’s health plan
Retiring before becoming eligible for Medicare
Purchasing individual or family health insurance
When Can You Enroll?
Open Enrollment
Covered California's annual Open Enrollment period runs from November 1 through January 31. During Open Enrollment, eligible Californians can enroll in a new plan, renew existing coverage, or change plans. Special Enrollment
You may not have to wait for Open Enrollment if you experience certain qualifying life events.
Examples can include losing job-based health insurance, getting married, having or adopting a child, moving, or losing eligibility for certain other health coverage. Most Special Enrollment Periods provide approximately 60 days to enroll following the qualifying event, although the rules and time frames vary by circumstance Timing matters. If you know you're going to lose employer-sponsored coverage, Covered California allows applications up to 60 days before that coverage ends, which can help prevent an insurance gap. Can Covered California Help Lower Your Premium?
Possibly.
Financial assistance through Covered California can include premium tax credits, which reduce monthly premiums, and cost-sharing reductions, which can lower deductibles, copayments and other out-of-pocket costs for eligible consumers who select an Enhanced Silver plan.
The amount of assistance available depends on factors such as your expected household income and household size.
Importantly, Covered California generally looks at your expected income for the coverage year, not simply what you earned last year.
That can be particularly important if you've recently:
Lost a job
Had your work hours reduced
Started working for yourself
Retired
Experienced another significant change in income
If your income changes during the year, you should update your Covered California account because those changes can affect the financial assistance you receive. Who Counts as Part of Your Household?
This is an area that often causes confusion.
For purposes of determining financial assistance, your Covered California household generally follows your tax household, including you, your spouse, and people you claim as tax dependents, even when every person in the household isn't applying for insurance. Simply living in the same home does not automatically make someone part of your Covered California tax household.
You Don't Have to Figure It Out Alone
Choosing health insurance involves more than finding the lowest monthly premium. Provider networks, prescriptions, deductibles, copayments and expected health care needs can all matter.
As an Independent Licensed Health Insurance Broker, I help individuals and families understand their options, compare available coverage, and navigate the enrollment process.
Cheryl Austin-Chaney
Independent Licensed Health Insurance Broker
Cheryl Austin-Chaney Health Insurance Solutions (CACHIS)
CA License #4557256
951-410-8448
Covered California is a registered trademark of the State of California. Cheryl Austin-Chaney Health Insurance Solutions is not affiliated with or endorsed by Covered California. Eligibility for enrollment, financial assistance and health coverage is determined according to applicable program requirements.
