Apply for Covered California Health Insurance

Posted: June 25, 2019

The Affordable Care Act significantly reduced the number of uninsured people in California. In 2013, the uninsured rate in the state was 16 percent, but that figure dropped to nine percent in 2015. That means there are still nearly three million people in the state without insurance. Cost is one of the top reasons people remain without health coverage. In 2018, premiums in California increased an average of 12.5 percent, and they are expected rise 8.7 percent next year.

Although price can be a barrier, health insurance is an important investment. If you get sick or have an unexpected accident, you will need to pay for that completely out-of-pocket without insurance. A three-day stay in the hospital can cost approximately $30,000. Most people do not have that kind of money on-hand, which means they will end up carrying a significant amount of medical debt.

Other uninsured people do not sign up coverage because they are intimidated by the process, but getting insurance through Covered California is quick and easy. You have the option to apply online or by phone. You can also print a PDF form to apply via fax or mail.

Use the following options to apply for a Covered California plan:

• Apply online: Start the process by getting California health insurance quotes.
• Apply by phone: Call 1-877-752-4737.
• Find an agent near you: Click here.
• Find a Covered California storefront near you: Click here.

Learn more about the process so you can feel confident and prepared to apply for health insurance coverage.

Open Enrollment and Special Enrollment

When you are applying for California health insurance, you need to know the difference between Open Enrollment and Special Enrollment.

• Open Enrollment: Open Enrollment is a three-month window during which anyone can apply for or switch health plans.

• Special Enrollment: Any time outside of the designated Open Enrollment period is considered Special Enrollment. To apply for Covered California insurance during this time, you will need to have a qualifying life event. Qualifying life events include losing your current healthcare insurance plan, permanently moving to or within the state, having a child, adopting a child, getting married, forming a domestic partnership, returning from active military service, being released from incarceration, gaining citizenship or if you are an American Indian or Alaska Native. Outside of those qualifying events, Special Enrollment is open to people whose enrollment was affected by technical issues on the Covered California website, people who experienced a natural disaster or medical emergency near the Open Enrollment deadline, and people whose provider left the network during the treatment of pregnancy, chronic illness, acute illness, terminal illness, the care of a newborn up to 36 months old or surgery that will happen within 180 days.

Regardless of when you are enrolling with Covered California, you have options to make it as easy as possible for you. You can print a PDF application in English, Spanish, Chinese or many other languages. You can also opt for live assistance with the application process. Agents, assistants, navigators and certified enrollment counselors are available to help you enroll in the health insurance plan that is right for you.

Covered California Application Deadline — The 15th of the Month

If you enroll with Covered California by the 15th of the month, your health plan will go into effect on the 1st of the next month. If you enroll after the 15th of the month, there will be a longer waiting period for the effective date of your health plan. The deadline of the 15th applies to applications submitted during Open Enrollment and Special Enrollment, but there are a couple of exceptions to know.

• Applications submitted between Oct. 15 and Nov. 15: If you submit your application during this early portion of Open Enrollment, your coverage will begin effective Jan. 1.

• Loss of coverage: Loss of coverage is a qualifying life event. If you lose your coverage and apply during the Special Enrollment period, you have the option to apply up until the last day of the month and have your coverage begin on the first of the following month.

Questions About the Application

If you feel overwhelmed by the idea of applying for insurance, you are not alone. Here are answers to some of the most frequently asked questions.

1. Who can apply?

Anyone who is a citizen of the United States and resides in California is eligible to apply for health insurance through Covered California. U.S. nationals and lawfully present immigrants can also apply. Anyone who is not a lawfully present immigrant cannot apply for Covered California insurance, but they may be able to obtain insurance through Medi-Cal or some private insurance companies.

2. How do I know if I am eligible?

As long as you are a U.S. citizen, U.S. national or lawfully present immigrant, and you live in California, you are eligible for health insurance with Covered California. Next, you can figure out if you are eligible for financial assistance through Covered California. Financial assistance is determined by the number of people in your household and household income as a percentage of the Federal poverty line. For example, if your income is 138 percent to 400 percent of the Federal poverty line, you qualify for a subsidy on a Covered California plan. You can view the Covered California program eligibility by Federal poverty level guidelines to learn more about your options.

If you have an offer of health insurance somewhere else, this offer could affect your Covered California eligibility. Are you or a spouse offered insurance through a job? Are you eligible for the Veterans Health Plan, full scope Medi-Cal or Medicare? These and other offers of health insurance may or may not make you eligible. Find out more if this is your situation.

Individuals and families who do not qualify for the premium tax credit are still eligible for Covered California coverage, but they will need to pay full price for their plan.

3. Where can I apply?

You have the option to apply online. To start this process, get a California health insurance quote. From there, you can navigate through the application process. You also have the option to apply over the phone by calling 1-877-752-4737. If you prefer to speak to someone in person during the application process, you find a local agent or a Covered California storefront near you.

4. When should I apply?

Generally, it is best to apply during Open Enrollment periods. The Open Enrollment period for 2019 runs from Oct. 15, 2018, to Jan. 15, 2019. During this time, anyone eligible for Covered California health insurance can apply and gain coverage. If you find you need health insurance outside of the Open Enrollment period, check the list of qualified life events. If you are experiencing one of those events, you can apply immediately during the Special Enrollment period.

5. What information do I need for my application?

Gathering all of the information you will need for the application ahead of time will make the process much faster. You will need this information for you and anyone else listed on your tax return for the current year, regardless of whether or not they are applying for health insurance. Have personal information including name, address, date of birth and social security number on hand. If applicable, have immigration information available. You will also need to know your tax filing status — single, married filing jointly or head of household. Finally, you will need your current income information. If possible, have your current pay stubs with you. This will help determine how much financial assistance you will qualify to receive when it comes to paying your health insurance premiums. Covered California determines program eligibility by reviewing income limits and the Federal poverty line.

6. What kinds of questions are on the application?

All of the information you gather to prepare for the application process will help you answer the questions. You will be asked to answer questions related to your personal information, your immigration status and your current income.

You should also know that the online Covered California system is not always able to verify information. If this is the case, you may be asked to provide a document of proof, which may include:

• Proof of income, such as a pay stub
• Proof of citizenship or lawful presence, such as a U.S. Passport or U.S. Passport Card
• Proof of California residency, such as a current California driver’s license
• Proof of minimum essential coverage, such as confirmation of termination of an employer-sponsored health insurance plan

If you are asked to send in a document of proof, do not worry. This is quite common. You will have 90 days to submit all required documents unless a different due date is specified. Generally, it is best to submit these documents as soon as possible.

7. Are there questions related to health conditions on the application?

No, you will not be asked about or required to share any information about health conditions on the Covered California application.

8. Are there questions related to smoking on the application?

No, you will not be asked about or required to share information about smoking on the Covered California application.

9. How long does the application process take?

Applying for health insurance does not have to be a lengthy process. Most individuals can complete the Covered California application process within 10 to 20 minutes. Most families can complete the process in less than an hour.

10. How do I pay for my coverage?

You will pay for your new health insurance after you have submitted your application. Be sure to take note of the payment deadline. During the enrollment process, you will be given specific payment instructions. If you miss the deadline, your enrollment will be canceled.

11. When will my insurance coverage become active?

When your insurance plan becomes active depends on when you apply for coverage. If you apply during Open Enrollment by the 15th of the month, your coverage will go into effect on the first of the following month. If you apply between Oct. 15 and Nov. 15 during Open Enrollment, your coverage will begin on Jan. 1. If you apply by the 15th of the month during the Special Enrollment period, your coverage will typically become active on the first of the following month with one exception. If your qualifying event is the loss of coverage, you can apply until the last day of the month. Then your coverage will become active on the first of the following month. You also need to ensure you pay your premium by the deadline for your health insurance policy to become active.

12. What should I do if I need help applying?

Everyone should be able to access healthcare. Applying for Covered California health insurance through Health for California is designed to be as easy and efficient as possible. That being said, it can still be overwhelming to apply for health coverage. You might feel confused if you’ve always had an employer-sponsored plan before. Maybe you’re not sure what information you need or how to submit it. You might feel more comfortable having someone walk you through the process the first time, or you may need help understanding the financial assistance options available to you. The help you need is available. You can speak to someone and apply over the phone, contact a local agent or go in person to a local Covered California storefront. The goal is to get covered, and we want to help.

13. Why Can’t I Apply?

Some individuals have had difficulty applying with Covered California insurance for varying reasons. If you try to enroll during the Special Enrollment Period, you will have to have a qualifying life event, or you will not be able to apply and receive coverage. However, the main reason many can’t apply is because they are still enrolled on Medi-Cal. California consumers have often tried to enroll with Covered California only to be denied coverage because they have not canceled their Medi-Cal coverage. In these cases, you will need to contact Medi-Cal to straighten things out before you will be able to apply with Covered California.

If you are qualified to apply during the Open Enrollment or Special Enrollment periods but still struggling to navigate the Covered California online application process, you have the option to get live assistance. Speak to someone on the phone, find a local agent or visit a Covered California storefront to get the help and coverage you need.

Time to Get Covered

Now that you know how the process works, you are ready to apply for Covered California health insurance. Get a free online quote for yourself or your family to prepare for Open Enrollment. If you have had a qualifying life event, you are eligible for Special Enrollment, and you can get started to today. Protect the health and future of yourself and your family by signing up for health insurance through Health for California.