How to Enroll into Coveredca.

How to Enroll into Coveredca.

 

Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates. It is administered by an independent agency of the government of California.

Coverage Levels

There are four different options.[17] Each option will determine how much a consumer will pay.

  • Bronze level: On average, the health plan pays 60% of covered health-care costs; the consumer pays 40%.
  • Silver level: On average, the health plan pays 70% of covered health-care costs; the consumer pays 30%.
  • Gold level: On average, the health plan pays 80% of covered health-care costs; the consumer pays 20%.
  • Platinum level: On average, the health plan pays 90% of covered health-care costs; the consumer pays 10%.
  • Minimum coverage plan (worst case scenario): If the consumer is under 30 and cannot afford the other plans, this is another option. It covers three visits with no out-of-pocket costs and free preventative benefits. The services will cost full price until the consumer spends $8,150. At that point, the services are covered completely by the health plan.

Essential Health Benefits

Since Covered California is a part of the Affordable Care Act, there are some essential health benefits that the insurance companies must offer to consumers. This is a list of a few services:[18]

  • Ambulatory services
  • Emergency/urgent care
  • Hospital care services
  • Maternity and newborn care
  • Mental health and substance abuse services
  • Prescription medication
  • Rehabilitation services
  • Laboratory services
  • Preventative and wellness care
  • Pediatric services

Dental Care

This is not required in the health plan. All Covered California health insurance plans provide pediatric dental care. Adults have the option of choosing supplemental dental care services in their plan.[19]

Vision Care

This is not required in the health plan. Covered California provides vision care for children, but does not offer any for adults. However, Covered California will work with certain companies to offer vision care directly to the adults.

Participating insurance providers

As of 2017, 11 insurance companies are participating in the individual and family exchange:

  • Anthem Blue Cross of California
  • Blue Shield of California
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Foundation Health Plan
  • L.A. Care Health Plan
  • Molina Healthcare
  • Oscar Health
  • Sharp Health Plan
  • Valley Health Plan (owned by Santa Clara County)
  • Western Health Advantage (partnership of Dignity Health Sacramento, UC Davis Health System and NorthBay Healthcare)
  • It is easy to Enroll.  First you need a good Certified Insurance Agent.  My  name is Gary Tuttle Lic #OH19662.  I have been with Coveredca. since the beginning.  This is my 8th year.  You will however need to call Coveredca. and have me appointed or delegated as your Ins. Agent.  This is the hardest part.  Once I have been delegated.  I will recieve a conformation from Coveredca.  Then I can enroll you thru my own Coveredca. website.  We can do this over tele.  It takes about an hour if you have all your tax forms and Ids.  So call Coveredca. and lets get you enrolled.  Call me 909-656-4885 if you have other questions.