Covered California is the marketplace where Californians can find and purchase affordable quality health plans. Established by the Patient Protection and Affordable Care Act law, Covered California helps you get health insurance that you need at a price you can afford. The following information should guide any Covered California virgin from application to renewal.
Covered California Health Plans Explained
Covered California offers four tiers of health plans categorized by cost and coverage:
Bronze Plans
Bronze organization offers smaller premiums tied to larger out-of-pocket whenever some services are accessed. It’s perfect if you never have or rarely need medical services and you prefer low monthly payments. Medical services costs are expected to be borne by bronze plans, which amount to around 60 percent of costs.
Silver Plans
Silver-funded plans are in the middle of the standardized premiums and total out-of-pocket costs. They contribute, on average, about 70% of the cost. The amounts are presented below the bars that show the medians of the cost differences between MEC and PEC with the respective Silver plan for a typical consumer that utilizes the six common medical services.
Gold Plans
Gold designs have higher premiums than silver but lower out-of-pocket costs than the latter. This may be best suited for you if you frequently need to see the doctor or to get tests or prescription medicines. Gold plans entail an average of $6,000 for the different costs regarding health expenses.
Platinum Plans
Platinum has the highest premiums and the lowest out-of-pocket when one seeks health services. At the same time, platinum plans are more premium and cover just about 90 percent of the cost of a medical procedure. It is recommended for those who require much attention in terms of their health status.In selecting a plan, you need to identify your expected usage and your financing capabilities within the coming year. Cost control plans cost less each month but get more when you seek care. Premium plans cost more in the process of the month but less in the time of service.Forcing of Relevance; Checking if You Qualify for Financial HelpAbout 85 percent of the consumers who sign up through the exchange receive subsidies to make their health plans fairly cheap. Based on your income, you are eligible for federal tax credits that directly reduce out-of-pocket monthly premiums. To learn about which tax credits and cost-sharing subsidies you can apply to minimize your total insurance expenditures, make a comparison on Covered California’s website in the Shop and Compare tool. The amount and type of income, as well as further information about your household, is used to check whether you qualify. If so, a rough estimate of savings is calculated.Increased needs may still get subsidies to make cost savings even if they earn more, and leisure needs may earn them subsidies. Eligibility is restricted by income, which rises each year and is in accordance with the guidelines of the federal poverty level. As for the existing discounts, speaking with a Covered California specialist will clarify what options you might be eligible for.
The Best Plan to Suit Your Needs
With such a large number of insurance plans provided, choosing a Covered California health plan surely does. Keep the following in mind when deciding:
Healthcare Providers
Make sure that the doctors, hospitals, clinics, and pharmacies you would want to visit are part of the insurance carrier’s network. It guarantees that services will be provided and eliminates shocking financial costs.
Prescription Medications
If you use prescription medication, ensure that the types of medication that you need are in the formulary list of the carrier but in the dosage and quantity you require. This will ensure that including your prescription is among the benefits of the plan that the insurance company is willing to offer you.
Total Expected Annual Burden
Add the monthly cost of the premium for the plan to the best ballpark figure for how much out-of-pocket expenses are in a year for services to determine overall yearly expenditures per category. Select the coverage that is available at the lowest total price.Getting advice from a licensed Covered California enroller at no additional expense is also recommended to make the selection more personal. They will also use your needs to appraise your position and provide you with plans that will ensure that you are financially feasible.
Purchasing Your Preferred Insurance Policy
Once you’ve compared health plans and chosen the best option, completing Covered California enrollment involves three steps:1. Create Your Online AccountAccount details such as full name, date of birth, contact details, and social security number will be required to create a safe online account. This means that you can shop for plans, apply for subsidies, and even enroll online.2. Submit Your Application An official application is to be filled in after logging into your account, and all members of the household who are to be covered must be indicated. You always want to be sure that the information you give is so accurate that there will be no problems or complications associated with it. 3. Make Your Initial PaymentThe last process is to pay the initial monthly premium that brings the coverage into force. Applicants are allowed to make payments through debit/credit card or bank transfer when applying for the program. With your consent, the insurance company to which we sent your application will then mail it to you, along with policy documents and ID cards.And with that, you will have active health insurance with the state of California through the Covered California portal. For now, you will be required to pay only monthly premiums whenever they are due.
Categories of the Frequently Asked Questions (FAQ)
Below are answers to some common questions about getting started with Covered California:Which period qualifies as open enrollment?The open enrollment period is October 15—January 15 yearly. This is the open enrollment period where you and everyone else are allowed to enroll in a health plan without any qualifying event such as job loss, change of address, marriage, etc.What if I join now? How soon do I start getting covered? If you register before the end of the year, your insurance begins on the first of the following year. If you sign up between December 16 and January 15, your coverage starts from February 1.Can I obtain quotes and compare programs without having to take a policy?Yes, as long as you are not an undercover cop, Covered California lets you browse through all the plans that are available in your location now and try to predict what the cost of any plan will be when you don’t have to sign up immediately so you can weigh your choices.When enrolling, what documents do I need to submit?Along with other requirements such as ID that proves you are a State resident and the name and income of all members of your household, they may also have requirements like docs proving your income red (tax returns or pay stubs) if you qualify for subsidies.What do I do if an alteration of my income occurs halfway through the year? Another thing is that if it happened in your household, you must inform Covered California within one month of an income change. It can change your subsidy amount and eligibility for certain plans regarding the new Federal Poverty Level Percentage.I hope you find this to be a great general guide to all matters pertaining to introducing yourself to the shopping process for health plans and enrolling, as well as applying for subsidies through the CA exchange, Covered California! If you have any questions or if you would like any clarifications, shoot me a message.
