Covered California’s annual open-enrollment period may be over, but if you are still uninsured, you may be able to get financial assistance to help you purchase health care coverage.
Between now and Oct. 31, those who are eligible can sign up for coverage through Covered California’s special-enrollment period, as long as they do so within 60 days of a qualifying life event. The following circumstances are among the more common reasons individuals become eligible for special enrollment:
- They lose their health coverage because they have lost or changed jobs.
- They get married or enter a domestic partnership.
- They have a baby, adopt a child or place a child for adoption or in foster care.
- They move and gain access to new Covered California health insurance plans that were not available where they previously lived.
- They become a citizen, a U.S. national or a lawfully present individual.
If you qualify under any of these conditions, you are eligible to get health insurance coverage and join your fellow Californians in having one less thing to worry about.
Make sure you take advantage of the financial assistance available to you and your family. An analysis by Covered California shows that its households received an average of $5,300 per year in tax credits to help pay for the cost of their coverage in 2016. Additionally, 12 percent of Covered California households receive more than $10,000 per year, and 16 percent of individuals receive more than $6,000 per year to help bring health coverage within reach.
Nearly half of all Covered California consumers, 49 percent, can get a Silver plan costing less than $100 per month. All of these consumers would benefit from financial assistance to lower their out-of-pocket expenses at various levels. In fact, 195,000 people, or 17 percent of current Covered California enrollees, can visit their doctor for only a $5 copay and will have an annual deductible of only $75 for an individual and $150 for a family. (The deductible only applies to hospital care.)
Those enrolled in “Enhanced Silver” plans, get the the additional benefit of cost-sharing reductions that reduce their out-of-pocket expenses by an average of $1,500 per year. More than half of all Covered California consumers receiving a tax credit, 59 percent, can get a Bronze plan for less than $10 per month. Bronze plans offer three visits to a primary care physician or specialist that are not subject to a deductible.
Californians have taken advantage of those savings. A new survey by the Centers for Disease Control and Prevention (CDC) shows that California’s uninsured rate has fallen to a new record low of 7.1 percent, which is significantly lower than the 17 percent the CDC found in 2013.
Covered California Executive Director Peter V. Lee said the exchange, which added 412,000 enrollees during the open-enrollment period that concluded on Jan. 31, is proud to be part of the effort that is helping millions of people get the coverage and care they need. Lee credited the expansion of Medi-Cal and the launch of a competitive state-based marketplace as the keys to empowering consumers and providing quality and value.
Prior to the Patient Protection and Affordable Care Act, California’s uninsured rate for all ages was higher than the national average: 17 percent compared to 14.4 percent. Since that time, California has fallen below the national average and is dropping at a significantly faster pace. The CDC says the difference between the two rates was one percentage point at the end of 2015. The difference between the two rates has now increased to 1.7 percentage points: 7.1 percent of California residents are uninsured compared to 8.8 percent nationally.
For more information on special-enrollment rules, visit: http://www.CoveredCA.com/individuals-and-families/getting-covered/special-enrollment.
Those who qualify for Medi-Cal may enroll through Covered California year round.
