Covered California is a marketplace where you can buy health plans with or without financial assistance after the Affordable Care Act (ACA) was passed. How much you pay for insurance is based on your income due to the ACA. Some people don't qualify for financial help, so it might be cheaper for them to sign up with a health insurance company directly. When you use Covered California, you are linked with name-brand health insurance. This means that you might be eligible for a Covered California discount on a health plan or Medi-Cal insurance. You'll have excellent health insurance either way!

There are many different health plans from which you can select.

Covered California provides four categories of private health insurance plans: platinum, gold, silver, and bronze, in addition to a minimum coverage plan.

Each group provides varying levels of coverage, ranging from extensive to minimal. More comprehensive health insurance plans typically have a higher monthly premium but lower out-of-pocket costs for covered medical services.

Platinum plans have the highest premiums, but they pay 90% of your healthcare expenses. Gold plans pay 80% and silver plans pay 70% of your health care expenses. Bronze plans have the lowest premium but pay just 60% of covered health expenses.

If you qualify for Medi-Cal, the coverage and costs will vary, and you may be eligible for free care.

Since the Affordable Care Act (ACA) was passed, Covered California can help Californians who don't have an offer of affordable coverage get a health plan! In addition, most immigrants qualify for health coverage, including the following groups: 

● Lawful permanent residents (green card holders).

● Lawful temporary residents.

● Persons fleeing persecution, including refugees and asylees.

● Other humanitarian immigrants, including those granted temporary protected status.

● Non-immigrant status holders (including worker visas and student visas).

People who are both lawfully and not lawfully present in the country can apply through Covered California to see if they qualify for a health plan through Covered California or Medi-Cal. There is no "waiting period" or "five-year bar" for either group. Immigrants who aren’t lawfully present do not qualify for a health plan through Covered California; however, they may qualify for coverage through Medi-Cal if they are younger than 26 or are 50 or older, if they are a DACA recipient, if they are currently pregnant, or were recently pregnant.

It is possible to obtain health insurance regardless of current or past health conditions. Beginning in 2014, the majority of health insurance plans cannot refuse coverage or charge you more if you have a pre-existing condition.

The cost of health insurance varies. The price is based on your estimated income for the coverage year, your ZIP code, your household size and your age due to the Affordable Care Act (ACA). Our health insurance agents can estimate and compare prices of the best coverage for you and your family.

If you are a low- or moderate-income Californian, you may get help buying insurance from Covered California through monthly subsidies that lower your premium costs so that you pay less for top-quality, brand-name insurance due to the Affordable Care Act (ACA). If your annual household income is somewhere between 0 and 600% of the Federal Poverty Line (FPL), you may qualify for financial help to afford health insurance.

If you make between 130 -400% of the FPL, you are eligible for premium tax credits. The Premium Tax Credit, or PTC, is a refundable credit that helps eligible individuals and families pay for the premiums of health insurance they buy through the Health Insurance Marketplace.

Any Californian who qualifies can purchase private health insurance through Covered California, regardless of income. We use your income to help us find the health insurance that is most affordable for your family.

We request that you submit any income changes to us, and we will process any new information to Covered California. And, we will tell you if the amount of your premium assistance changes.

For adults, the following Covered California income restrictions apply:

0% – 138% of FPL: You qualify for Medi-Cal.

> 138% – 400% of FPL: You qualify for a subsidy on a Covered California plan.

> 138% to 150%: You also qualify for the Silver Enhanced 94 Plan.

> 150% to 200%: You also qualify for the Silver Enhanced 87 Plan.

> 200% to 250%: You qualify for the Silver Enhanced 73 Plan.

This is the current program eligibility by Federal Poverty Level for 2023. There may be changes in 2024.

Open enrollment for Covered California starts in the fall -usually from November to January. Currently, the deadline for Covered California Open Enrollment for 2024 is to be announced. Medi-Cal enrollment is year-round.

Even when open enrollment is over, individuals with qualifying life events can enroll at any time of the year.  You can apply for a health plan outside open enrollment (or make changes to your current plan) if you’ve experienced one of these qualifying life events, usually within the last 60 days. Or, find out if you qualify for Medi-Cal by contacting our office!

Qualifying Life Events:

● Lost Health Insurance

● Turned 26 Years Old

● Moved to or Within California

● Married or Entered a Domestic Partnership

● A Child is Born, Adopted or Received into Foster Care

● Change of Household Size

● Domestic Abuse or Spousal Abandonment

● Affected by Wildfires

● Returned from Active Military Service

● Released from Jail or Prison

● Gained Citizenship or Lawful Presence

● Current Enrollees Who Experience a Life Event

There are additional qualifying major life events. Contact us and we can see if your major life event qualifies you to enroll during a Special Enrollment Period.

Coverage will usually start on the first day of the month following plan selection (for example, if you selected a plan on Dec. 31, your coverage would start on Jan. 1).

During the year, you must report any changes to the information you put on your application. Changing your address, the number of people in your family, or your income can affect whether you qualify for Medi-Cal or whether Covered California will help you pay for your health insurance.

People who get Medi-Cal must tell their local county office of any changes within 10 days.

If you get your health insurance through Covered California, you have 30 days to tell the program about any changes.

Once enrolled in Covered California, you will need to report changes if you:

● Get married or divorced.

● Have a child, adopt a child or place a child for adoption.

● Have a change in income.

● Get health coverage through a job or a program like Medicare or Medi-Cal.

● Move.

● Have a change in disability status.

● Gain or lose a dependent.

● Have a change in tax-filing status.

● Have a change in citizenship or immigration status.

● Are incarcerated or released from incarceration.

● Have a change in status as an American Indian or Alaska Native or change your tribal status.

● Have a correction to your name, date of birth or Social Security number.

● Experience any other changes that may affect your income and household size.

We can help you report any changes that occur throughout the year, making the process easier on you. Simply delegate us as your servicing agent and we will submit the changes for you.

There is no fee to “delegate” us as your service agent on your account.

Call us for assistance: (916)-346-4417