While parts of The Affordable Care Act have been repealed, California continues to uphold the $695 penalty for anyone without health insurance coverage. Throw in out-of-pocket expenses and going without a healthcare plan is no plan at all. If you’re ready to pick up health insurance and save on medical expenses, then here’s what you need to know.
Getting Started
The easiest way to start an application is through Covered California, the state’s primary insurance website. You can choose to apply online, by phone, or use the storefront finder to apply in person. Before applying, you’ll need the following documents:
- Social Security Number
- Pay stubs of proof of unemployment
- Federal tax information
- Immigration documents if you are a non-citizen
If you choose to apply in person, simply set an appointment and bring your documentation with you. Applications by phone are similar to those in person, but you must email any required documents to Covered California. To apply online, you begin by creating an account with a username and password.
When applying in person, you can also choose to see a local insurance agent. These agents receive commission from health care companies, alleviating any cost to you for their services. It’s an excellent way to learn more about your options and have any questions answered during the process.
Applying for Coverage
You can apply for various types of coverage during open enrollment, but need a qualifying life event to pick up insurance outside of enrollment periods. Qualifying events include getting married, having a child, returning from active duty, and recently gaining citizenship. If you are about to lose your coverage or recently moved to California, you also qualify for special enrollment.
Outside of open enrollment, you can apply for Medi-Cal insurance at any time. Medi-Cal is a state program that covers low-income families through Managed Care Organizations. As a benefit, there are no costs for coverage. This option is best for those over 65, with disabilities, or those who make less than $1,271 in a month.
Comparing Coverage
Perhaps the most important aspect of signing up for a healthcare plan is to compare the types of coverage they offer. Various plans are designed to meet different medical needs for individuals as well as families. The Most popular are the bronze, silver, gold, and platinum plans.
The Bronze 60 plan is ideal if you rarely visit the doctor and take no medications, keeping your costs low with basic catastrophic coverage. Platinum 90 comes with the highest monthly payment, but works best if you or your family need frequent medical care.
The Silver 70 plan covers basic medical care. However, you’ll spend a little more for hospital visits and outpatient surgeries. If you need those aspects covered, then the Gold 80 plan is a better option for lowering your deductible.
You also must choose a regulator. There are Health Maintenance Organization (HMO), Preferred Provider Organizations (PPO), and Point of Service (POS) plans. An HMO covers you inside of the supplier’s network, allowing you to visit their hospitals and doctors. A PPO covers part of the cost of out-of-network expenses but increases the cost of in-network prices slightly. A POS plan lets you choose between HMO and PPO coverage when you need care.
Sources:
- https://medlineplus.gov/managedcare.html
- https://www.healthforcalifornia.com/individual-and-family-quote?msclkid=772a1490c46d114cc3e44911e7d34627&utm_source=bing&utm_medium=cpc&utm_campaign=opt%20-%20covered%20california&utm_term=covered%20california&utm_content=covered%20california-e
- https://ca.db101.org/ca/programs/health_coverage/medi_cal/program2a.htm
- https://www.coveredca.com/