Many Californians have given up on obtaining insurance over the last few years. This is obviously not a great decision.
The reasons are obvious. First, you can get seriously ill without warning. This can ruin you and overwhelm you financially. It’s a shame to deprive yourself of an insurance company that would take care of it for you. But that’s not all. You can also be fined if you do not have insurance that meets a basic level of vitality coverage.
Learn what is Covered California and why it’s a good option for you here. Or if you’re ready for a quote, you can get your Covered California Quote here.
What’s Covered California? What Are My Options?
Covered California was created to provide California residents with branded insurance under the Patient Protection and Affordable Care Act.
This exclusive and free service provides financial help to people who buy insurance from the most reputable American companies. At the time of your application, you can:
- Receive a discount on a health plan under Covered California
- Get insurance through the state Medi-Cal program
Whatever your situation, the health coverage you’ll get will be excellent.
Is Covered California Plan the same as Obamacare?
For the purposes of the program, the state of California is covered by the national Affordable Care Act (ACA) which is sometimes called Obamacare. This gives you the same opportunities with the Covered California plan as with the Obamacare one.
Levels of Coverage
The Covered California plans have four different levels of coverage:
The exchange helps Californians follow the ACA/Obamacare regulation. The program enables residents and their families to have health coverage that includes the basic care required by U.S. law.
There are licensed companies that offer subsidized care plans and dental or vision coverage funded by this Exchange. Coverage in California allows the sale of insurance, whether it is part of the Exchange or not. Harmony Health is the place to go if you need assistance in navigating through this marketplace.
What income level qualifies for Covered California Coverage?
Covered California recipients are entitled to financial help that reduces their premiums if their household income is less than 400% of the Federal Poverty Level (FPL). It is more commonly known as a “Subsidy.
If their household income is between 138% and 250% of the FPL, Covered CA recipients are also eligible for more discounts, otherwise known as “Cost Sharing Reductions.”
What are the eligibility requirements?
If you want to qualify for a subsidy and, if applicable, a reduction in cost-sharing, your income must not exceed the thresholds set by Covered California. You must also not have already received an affordable and comprehensive health care package from your employer.
You need to have qualified health coverage/span>
In order to comply with the mandate, a person must be enrolled in a qualified health plan. What is a qualified health plan? It’s a program that meets all the requirements set by the American government and that provides a basic level of coverage.
When is a plan considered essential? Essential health benefit (EHB) plans must cover vital care items such as:
- Preventive services
- Drug prescription
- Maternity and newborn care
Is Covered California the same as medical?
It is possible to benefit from a medical plan if it is dated before March 23, 2010. This is a medical plan that was in effect before the adoption of the mandate and that has not undergone substantial changes.
The Health Coverage Application Process
Your application is automatically checked to determine if your family is eligible for financial coverage, regardless of when you applied.
You can apply from the comfort of your living room by calling Covered California, or you can go to a point of service in your neighborhood. Whichever option you choose, registration is free and confidential. Harmony Health can help you to navigate through your options.
Some of the necessary documents you will need:
- Your social security number
- Your date of birth
- Information on your family members’ current income
- Immigration documents if applicable to you
Several application sources
You can apply for a qualified medical plan through several sources:
- Covered California
- A group insurance
- A military plan
- A non-Exchange operator
If your employer or a public program such as Medicare or Medi-Cal does not allow you to get insurance, you can do it yourself with the help of Covered California.
All the insurance companies comply with the requirements of each federal government. In the case of the state of California, they also comply with the criteria set by Covered California.
Companies associated with Covered California
This program includes quality medical coverage from the following companies:
- Anthem BlueCross
- Blue California
- Kaiser Permanente
- LA Care Health Plan
- Valley Health Plan
- CCHP Health Plan
- Molina Healthcare
- Western Health Advantage
- Sharp Health Plan
You can choose the company that best suits your needs and those of your family. The range of options is wide and affordable, without reducing the quality of care covered.
Dental care is considered a basic medical intervention for children. For this reason, all health plans offered by Covered California include dental coverage for children under the age of 19.
Adults can also enjoy dental coverage under a family plan, regardless of whether or not you have children. You must go through Covered California in order to benefit from it.
Good news for children: your vision care is included in all health plans through Covered California. Again, this service is considered basic.
Less good news for adults, for whom this care is not vital and therefore necessary. But don’t worry, Covered California is in collaboration with EyeMed and VSP who will take care of your treatment.
Covered California offers excellent care coverage with tax credits for pregnant women meeting the following conditions:
- If your income is too high to allow you to benefit from Medi-Cal
- If you are a U.S. citizen, U.S. national, or are legally present in the United States
- If you are registered with Covered California
It is possible to subscribe to an insurance plan from Covered California every year. Applications are accepted during the open registration period. If you wish to enroll in a plan outside of this period, you can only do so if you have a special event.
There is a small exception with Medi-Cal: enrollment is open all year round and with the same application as Covered California.
In order to be eligible for an insurance plan outside the registration period, an exception can only be made in case of one of the following events.
- Loss of insurance
- Moving within the State of California
- Birth of a baby
- Adoption of a child
- Conclusion of a domestic partnership
- Return from active military service
- Release from incarceration
- Obtaining citizenship or legal presence
- American Indian/Alaskan Native
Each event is subject to fairly strict rules. You have to be able to prove the urgency of your situation.
High-quality service for all Californians
Covered California carefully chooses the insurance companies it collaborates with. Among the most important selection criteria are the quality of medical assistance and the overall value of the coverage offered. No one is left out, and the quality of care is not relative to:
- Ethnic origin
- Skin color
Covered California guarantee
The ultimate goal is to match each Covered California registrant with a nearby clinician to provide essential care. It also aims to prevent people in need from resorting to inexpensive but very dangerous practices.
Everyone Can Submit An App
You are likely to be admitted to a health plan regardless of your legal status. All you have to do is ask!
For Covered California, proof of legal presence in the country is required. But if you don’t have it, you are still potentially eligible for Medi-Cal coverage until the age of 26. Some counties also offer other options for illegal immigrants. For example, you can use a private insurance company outside of Covered California. Pregnant women are covered regardless of their situation.
Many Covered California subscribers apply for financial help to help fund their medical coverage.
Are you legally present in the United States? Do you meet the eligibility criteria for California income and residency? If so, you may be eligible for financial help to get a Medi-Cal insurance plan or any other coverage plan offered by Covered California.
Penalties for non-insured families
U.S. law requires that all residents of the United States have health coverage. If you do not respect this rule, you may be fined by the California Franchise Tax Board.
How much is the fine?
When you file your income tax return for the year 2020, the penalty for failing to provide coverage for the entire year is at least $750 per adult and $375 per child. The child must be dependent on the family and be under 18 years of age. For families of four members who have not purchased year-round insurance, the amount of the penalty will be at least $2,250.
Covered California can help you avoid the penalty
Covered California is able to help you avoid the consequences of this penalty. California is providing additional budgetary support to families who cannot afford insurance.
Currently, about 500,000 low-income people are saving about $600 per month with this assistance. You’ve now learned what is Covered California–contact Harmony Health to get help with coverage options!