From health insurance premiums to out-of-pocket costs, you’ll no doubt agree that finding affordable insurance is hard. The average American spends more than $10,000 per year on healthcare expenses—nearly enough to buy a brand-new car. With these types of bills, going without health insurance can be far riskier than expected—and with the advent of the Affordable Care Act (ACA) and California’s accompanying marketplace, Covered California, obtaining affordable insurance is within your reach. Read on to learn 7 things you need to know before you can apply for Covered California open enrollment plans and what’s the key to finding affordable insurance.
When is the Covered California Open Enrollment Period?
The open enrollment period for Covered California plans allows any resident within the state to apply for health insurance without a qualifying life event (like marriage, divorce, death, job loss, an out-of-state move, or the birth of a child). This year, you’ll be able to apply for Covered California healthcare between October 15, 2018 through January 15, 2019.
What Happens if You Miss the Open Enrollment Deadline?
After January 15, 2019, you’ll only be able to apply for Covered California health insurance plans within your individual Special Enrollment Period, or SEP. The SEP is triggered by one of the following qualifying life events:
- Job loss (whether voluntary or involuntary)
- A move to a new state
- Marriage, divorce, or annulment
- The death of a spouse
- Aging off a parent’s health insurance plan
- The birth of a child
If you’ve gone through a qualifying life event within the last 60 days, you can apply during your SEP, but once this 60-day deadline passes, you’ll need to wait until October 15 (or the beginning of the next open enrollment period) to apply for Covered California.
It’s important to note that the SEP isn’t triggered if you voluntarily canceled your previous insurance coverage or if your coverage lapsed due to a missed payment; individuals in these circumstances will also need to wait for the next open enrollment period or go through another qualifying life event.
However, if you’re applying for Medi-Cal (California’s Medicaid program), the Children’s Health Insurance Program (CHIP), traveler’s health insurance, or one of several health care sharing plans, you’ll be able to enroll in these programs year-round.
How do You Apply for Covered California Plans?
Whether you’re going through Covered California open enrollment for the first time or are modifying your current coverage, you can make your selections at any time during the open enrollment period through the online application available at apply for Covered California.
If your household income is between 128 and 400 percent of the federal poverty level (FPL), you’ll qualify for a tax credit that will offset the cost of your Covered California plan premiums. Those with incomes below 128 percent of the FPL can qualify for Medi-Cal. Charts are available online that can help you determine, at a glance, whether you’re likely to qualify.
Filling out your Covered California application will automatically cross-check your income to determine which subsidies may be applicable; but if you’d rather keep this information private, you use a separate application that doesn’t use your income as a selection factor, waiving any premium subsidies in the process.
What Plans Are Available?
Our agency is member of the Trusted Choice network of Independent Insurance Agents, we’re not tied down to the Covered California health insurance plans. We’re going to start by shopping for the most affordable insurance plans available on and off the exchange marketplace for the best healthcare options. You can find Covered California’s plans on
our “Shop and Compare” tool that helps you estimate costs and learn more about the coverage options that are available in your city and county. By entering a few pieces of personal information (including age, income, and zip code), you can learn whether you qualify for premium subsidies and which plans from the Bronze, Silver, Gold, and Platinum tiers make the most financial sense for your unique situation.
While this isn’t an exhaustive list of the providers available, for most Covered California open enrollees, one or more of the following providers may be able to extend affordable coverage to you and your family:
- Blue Shield Covered California
This California-based not-for-profit health plan offers coverage to those purchasing through Covered California. The specific Blue Shield Covered California plan you’ll choose depends on what’s available in your region, but all Blue Shield Covered California health insurance plans currently include pediatric dental coverage in addition to health coverage.
- Health Net Covered California
Health Net offers individual and family plans during Covered California open enrollment. Their user-friendly website makes it easy to choose providers and determine which plans are ideal for your situation and needs.
- Covered California Kaiser Plans
California-based healthcare giant Kaiser Permanente offers affordable healthcare insurance and dental plans for individuals, couples, and families through their Covered California website.
Regardless of whether any or all of these plans are available to you, the Covered California Shop and Compare tool lets you compare factors like co-pays, premium costs, deductibles, in-network physicians, and estimated out-of-pocket costs for each plan.
What Should You Know Before Selecting a Plan?
In order choose an affordable insurance plan, it’s a good idea to gather together your medical bills, pay stubs, prescription receipts, and any other healthcare-related documentation your family has generated over the past couple of years. By getting a good idea of the number of doctor visits you’re likely to have over the next year, your average prescription costs, and your budget constraints, you’ll be in a better position to know whether you’d save money through a high-deductible health plan or need the low deductibles and broad coverage of a PPO.
What Happens After You’ve Chosen Your Plan?
Once you’ve filled out the application, compared available plans, and made your final selection, you’ll need to pay your first premium bill in order to finish the enrollment process and start the clock on healthcare coverage. For many plans, you’ll be able to make this payment online after filling out your application, providing you with near-instant coverage with a click. In other cases, you’ll need to send in a paper check or a credit card payment and wait to receive coverage confirmation.
Because Covered California is an insurance marketplace, not an insurance provider, it won’t accept checks for your premiums or bills. For those who can’t make payments online, make sure you’re making your monthly payments directly to the insurance company that provides your coverage to ensure continuity of coverage.
Finding affordable insurance is a challenge and if you choose the wrong plan you’re probably stuck with it for the entire year until the next open enrollment. An insurance advisor can help you make the right plan selection that fits your budget.
Protect what’s most important to you by adding life insurance to your financial portfolio. Contact us at 866-936-3831 and speak with a licensed agent. Gary W Blackmon is a licensed life and health insurance agent and has customers from California to New York. He will be glad to help you with your coverage options. If you have any questions, need assistance in enrolling, or would like to obtain a quote specific to you, please contact him.
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