10 Things to Know About the Covered California Health Insurance Exchange

Covered California is the state's health insurance exchange, a place where individuals can purchase health plans during Open Enrollment.

Covered California is the state's health insurance exchange, a place where individuals can purchase health plans during Open Enrollment.

On October 1, 2013, the ObamaCare state insurance exchange was launched. California's exchange, Covered California, also opened for business. The Covered California health insurance exchange is determined to improve hospital health care for Californians to make it more affordable and value-based with various brand-name health insurance plans. The plan is expected to not only help individual consumers but also to help business owners struggling with escalating California health insurance rates.

  1. What is Covered California?

Covered California, simply put, is a marketplace for the group and individual health insurance, and it will also offer health insurance to all. Support is available for eligible individuals and families that don’t have the finances to buy health insurance.

2. Covered California health insurance exchange requires U.S. citizens, U.S. nationals, and permanent residents.

Just like the rest of the U.S., U.S. citizens, permanent residents, and U. S. nationals in California are eligible to have health coverage that meets minimum coverage requirements. You do not qualify for health coverage if you aren't in the United States lawfully. You can only be enrolled in private health insurance, and won't be eligible to enroll in a California health insurance exchange. Also, you can be charged a tax penalty when you don’t pay for two months health insurance in a row or longer unless you qualify for an exemption.

3. You can select from a range of plans.

The health plans available in Covered California are grouped into four metal levels. The health plans available on the California health exchange along with the costs you are expected to pay for health plans in each category are shown by the metal levels below:

  • Bronze level: On average, your plan pays 60% of covered health-care costs; you pay the remaining 40%.
  • Silver level: On average, your plan pays 70% of covered health-care costs; you pay the remaining 30%.
  • Gold level: On average, your plan pays 80% of covered health-care costs; you pay the remaining 20%.
  • Platinum level: On average, your plan pays 90% of covered health-care costs; you pay the remaining 10%.

4. All the plans come with the same essential health benefits.

You don’t have to worry about the essential health benefits you can gain from health insurance plans, as they all cover benefits like doctor visits; emergency care; hospital care; preventive screenings; care for children, infants and pregnant women; and prescription drugs.

5. It’s not essential to buy from the marketplace.

It’s not compulsory, as health insurance companies will continue selling insurance outside the marketplace, and buying from them is not essential. You can go ahead and buy a non-market policy if it suits you better.

6. Forget about being denied.

You don’t have to worry if you have the pre-existing condition and if your health insurer fails to cover you; health insurance can now be bought quickly at the new marketplace where the insurer cannot deny coverage. Your age, pre-existing condition, gender or health status that may have caused your rejection in the past, does not have anything to do with your approval.

7.  There is a penalty for…

You are at the risk of facing a penalty that will be collected through your income tax return if you don’t have health insurance coverage. The penalty will increase each year, and it will be based on your income.

8. Enrollment happens once a year.

Covered California health exchange open enrollment occurs once a year. It begins on November 1, 2017 and ends January 31, 2018.

9.  No more federal subsidies.

President Donald Trump declared that there will not be federal subsidies but he is working to repeal the Affordable Care Act, just as promised in his campaign. The federal government also said, “it will no longer pay insurance companies to provide discounted coverage for low-income people.” “I think it’s about people being confused about what’s happening in the marketplace right now,” said Catherine Perez, co-founder of HealthSherpa (Luery, 2017).

10. The majority of enrollees will pay less.

According to Covered California, “about 1.1 million of the 1.3 million people enrolled that pays less for coverage and about 1.5 percent less on average”. However, those who make too much money are the hardest hit to qualify for federal assistance. While the individual marketplace is the only place those that enrollees must buy coverage.

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