The options available to Californians without health insurance has changed significantly with the advent of the ACA law and Covered California. Let's look at the options and keep in mind that everyone's situation is different and often complicated. A quick 5 minute call can usually narrow the options to the best one so feel free to call at 800-320-6269. In the meantime, let's look at the key avenues. Let's break this down to key drivers of why a person is uninsured.
Whether you're losing group health coverage (through an employer) or as a result of other changes (moving to California, turning 26 as a dependent child, etc), there are options available. Here are the key options:
1. Cobra. Cobra refers to the ability to continue group health insurance where the employees pay the full premium out of pocket. The coverage and networks are identical. There's more information on Cobra here but it generally lasts for 18 months with some people have an option for an additional extension called Cal-Cobra.
Pros. Same coverage and networks. Networks on the group market are bigger than the new individual/family networks. Benefits are also the same as prior group plan.
Cons. Very expensive generally. Locked into same carrier or plan you had before which might not work with new budgetary or health needs.
2. Covered California
Losing health insurance generally falls under the "Special Enrollment" category for Covered Ca. We should be able to enroll you right away.
Medi-cal enrollment can happen any time (even outside of open enrollment) if you are pregnant or if your income falls under a certain range. You can check the income ranges here. Pregnancy is also a special trigger for Medi-cal. Please contact us if you might find yourself eligible this option.
There are other special triggers that allow people to qualify for coverage outside of Open Enrollment (traditionally Nov 15th - Feb 15th but check with us for current year). These are the main triggers:
• Getting married
• Gaining a dependent or becoming a dependent
through marriage, birth, adoption, or placement for
adoption
• Permanently moving to a new area that has
different health plan options
• Losing other healthcare coverage that is
considered minimum essential coverage (Note:
Voluntarily quitting other health coverage or being
terminated for not paying your premiums are not
considered a qualifying event.)
• A change in income that would affect an enrollee's
eligibility for financial assistance
• Becoming a U.S. citizen
• As a result of an error, misrepresentation, or
inaction by a QHP or agent
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!