Covered CA Plan Benefit Changes for 2021

Posted: September 23, 2020

Minor Benefit Changes on Bronze, Silver, Gold and Silver 87

The Golden State is getting a pleasant surprise in 2021. Covered California rates are going up 0.6% on average and the plan benefits are not changing very much.

Bronze, Silver and Gold

The out-of-pocket maximum is going up from $7,800 to $8,200 on the Bronze, Silver and Gold Plans. For Bronze and Silver, there are no other benefit changes for next year.

Gold Plans Have the Most Changes

On the Gold Plans, there are a couple more changes beyond the out-of-pocket maximum going up $400. Doctor Visits and Urgent Care are both going up $5, from $30 per visit to $35 per visit. For Gold Plans that have a copay for Imaging (including CT, PET Scans, and MRI’s), the copay is dropping from $275 down to $150. For Gold Plans that require a percentage payment for Imaging, that amount will remain at 20%.

Silver 87

For the Silver 87 Plans, there is one small change. The out-of-pocket maximum is going up $150, from $2,700 up to $2,850.

In 2021, consumers can look forward to small rate changes and minimal benefit changes. Also, if Californians switch plans to the lowest priced plan within the same metal tier, they will save on average 7.3%.