Covered California 101 – Oct. 16, 2020
At One Community Health in Sacramento, we believe that healthcare is a right, not a privilege—a lack of income or health insurance should never be a barrier to receiving quality health care. In our last two posts, we discussed some of the options you have if you have lost your health insurance. Today we’ll look at one of these options—Covered California—more in depth and see how it differs from Medi-Cal coverage. Whether you are looking for clinics that accept Covered California, or you aren’t sure what your options are, we are here to help you and your family.
What is Covered California?
This is our state’s health insurance marketplace. With this program, Californians can get high-quality insurance coverage from top insurance companies through the Patient Protection and Affordable Care Act. With financial assistance and tax credits, you can find affordable health insurance plans.
Who is eligible?
Your financial assistance eligibility will be determined by the federal poverty level (FPL). These levels are set by the Federal Government. Refer to the federal poverty level chart to estimate your percentage of FPL. If you need assistance, please let us know.
Health insurance premiums are based on:
- Your age
- Your ZIP code
- Your household size
- Your projected household income
- The health plan and benefit level you select
How does it differ from Medi-Cal?
Medi-Cal offers very low-cost or free health coverage to eligible low-income California residents—it is California’s version of Medicaid and operates like an HMO. Covered California is the state’s health insurance marketplace where Californians can shop for affordable health plans and access financial assistance and tax credits. The primary difference is the cost, which is based on income eligibility. Insurance plans available through Medi-Cal and Covered California both offer essential health benefits.
How do I apply?
To apply for insurance through Covered California, go here. The application is the same as for Medi-Cal—after you complete your application, you will be informed of which program you qualify for. Our Community Resource Team is also available to help you navigate the application process. Call us at 916-443-3299 to set up an appointment.
When can I apply?
Open enrollment is Oct.15, 2019, to Jan. 31, 2020. However, if you have recently experienced a qualifying life event, you can enroll at any time of the year. Qualifying life events include:
- Losing health insurance
- Moving to or within California
- Being released from prison
- Getting married
- Having a baby
For a comprehensive list of qualifying life events and specific circumstances that are covered, refer to this webpage.
We are Here to Help
Our team at One Community Health understands how difficult it is to navigate the complex health insurance world, especially during this stressful time. That is why we have set up a Community Resource Team to help you find and apply for the insurance option that is right for you and your family.
We are also an FQHC, or Federally Qualified Health Center, which means we provide medical and mental health services free of charge for those who cannot pay or do not have health insurance. If you are looking for clinics that accept Covered California, be sure to give us a call to set up an appointment. For a full list of the services we offer, refer to this webpage. We look forward to supporting you and your family in all of your physical and mental healthcare needs regardless of your ability to pay.