Covered California, the state-run health exchange set up for individuals and families to compare and purchase comprehensive, affordable private health plans, offers a wide range of information and options, and if you're confused, you're not alone. According to Covered California officials, less than one-third of new enrollees have gone through the process on their own. The rest have sought help through a number of valuable sources, including certified enrollment counselors, licensed insurance agents and other experts.
If you're planning to get health insurance through Covered California and haven't enrolled yet, or you currently have a Covered California plan and want to switch to a different one, time is running out. The 90-day open enrollment period for Covered California ends Feb. 15. After that, everyone is required by the federal Affordable Care Act to have health insurance. If you don't have it, you will have to pay a penalty when filing your taxes.
Eligibility for Enrollment
If you are a U.S. citizen or legal U.S. resident and do not have access to health insurance through a private company, your workplace, a family member's employer, or a government program such as Medicare or Medicaid, you can enroll in a Covered California health plan at www.coveredca.com. Legal residents include U.S.-born children of undocumented immigrants. There is no risk of deportation or legal action to families of mixed immigration status if children who are legal residents are enrolled in a plan.
In addition, the Covered California website will help you determine whether you qualify for financial assistance, such as subsidies or federal tax credits, to reduce the cost of your health insurance premiums. If your income drops below a certain amount, the state could enroll you in a Medi-Cal plan instead.
The Affordable Care Act requires every newly purchased insurance plan to cover essential health benefits such as doctor visits, hospitalization, emergency care, maternity care, pediatric care and prescriptions. You cannot be turned down for coverage, or charged a higher premium, if you have a pre-existing health condition or become ill. If you sign up by Feb. 15, your coverage will be effective March 1, 2015.
How to Enroll
There are several ways to enroll in a Covered California plan: online, in person, or by phone. Online enrollment is available only through the Covered California website.
Scripps Clinic and Scripps Coastal Medical Center doctors are in-network providers on the Covered California Blue Shield PPO (preferred provider organization) and Blue Shield EPO (exclusive provider organization) plans. Additionally, Scripps hospitals accept all Blue Shield, Health Net and Molina plans offered through Covered California.
If You Miss the Deadline
If you do not sign up by the deadline, you will be charged penalties and fees for not having insurance? either 2 percent of your household's yearly income, or $325 per person age 18 and older and $162.50 per child, whichever amount is greater.
Moreover, you won't be eligible to enroll in a Covered California plan until 2016 unless you have a life event that qualifies you for special enrollment, such as a marriage or domestic partnership or a new child. If you move to another state or lose insurance coverage from another source, you also may qualify.
Still Have Questions?
Free, expert assistance with Covered California is available throughout San Diego County, so don't hesitate to get help. Covered California has a toll-free service center at (800) 300-1506 and several community storefronts countywide where you can get help in person.
For more information about the free Covered California events, please visit: www.Scripps.org/EnrollmentEvent.
"To Your Health" is brought to you by the physicians and staff of Scripps. For more information, call 1-800-SCRIPPS (727-4777).