What is Covered California and How Does it Work?

Covered California is the state of California’s health insurance “marketplace,” otherwise known as part of the Affordable Care Act. Since it is a statewide “shop” to get health insurance, it is easiest to apply online to find out exactly what you qualify for. Individuals and families who believe they qualify for financial assistance to help pay for health insurance are encouraged to apply through Covered California instead of directly with a health insurance company. Depending on the size of the household and annual income of a person or couple, Covered California health insurance plans can be subsidized in different amounts. It should also be noted that these plans are big-name health plans like Blue Shield, Health Net, Kaiser, Anthem Blue Cross, and others depending on your location in California.

The application will ask you for detailed information such as:

• Names of each person in your household
• Dates of birth for each person
• Your address
• Social Security numbers
• Income information (Adjusted Gross Income)
• Documents to support income and residence (i.e. tax return, pay stub, bank statement, California ID/Driver’s License, etc.)

It is also important to note the following:

– If you are only looking to insure some family members in your household, but there are others you claim on your tax return, you will still need to include all family members on the application. You will be able to choose which family members you are seeking insurance for at some point on the application, but in order to determine exactly what you qualify for, Covered California needs to account for all household members that are included on your tax return.

– If you are married and looking to enroll in health insurance, you MUST file taxes jointly with your spouse as that is the only way to qualify for financial assistance when you are married. If you file taxes separately, you will not qualify for financial assistance.

– The annual household income that Covered California asks to verify is your Adjusted Gross Income, which is usually found on line 37 on your tax return. However, if you are projecting your income will be different than what you have on the last tax return you filed, then you will need to submit your income as the new number you are estimating. Covered California wants you to state your income as close as possible to what you believe will be what you make at the end of the year. If you find mid-year that the income you submitted on your application is less or more than what you stated initially, you may adjust your income on your application to reflect it more accurately. It is always encouraged to adjust your income if you notice it will be different than what you projected so your monthly premiums and financial assistance are adjusted accordingly. If you end up receiving more financial assistance than you were supposed to, you may have to pay that back when you file taxes the following year. If you end up receiving less financial assistance than you actually qualified for, you may receive a refund at tax time. This will all depend on how accurately your income is reported on your Covered California application.

Considering the many details Covered California requires along with certain documents like proof of income and/or residence, it is recommended to get assistance from a local Certified Insurance Agent that is partnered with Covered California. This will ensure you are submitting all documents and information accurately and timely in order to receive the correct information from Covered California. It is also useful to get help from local agents as they can recommend the best plans that would fit your and your family’s needs.

At California Well Being Insurance Agency, we are committed to providing the utmost customer service to those seeking health insurance and can provide assistance enrolling in a Covered California plan. Please do not hesitate to reach out to us by clicking here and giving us a call to discuss your health insurance options.