What is Covered California?
Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It’s the only place where you can get financial help when you buy health insurance from well-known companies. That means when you apply, you may qualify for a discount on a health plan through Covered California, or get health insurance through the state’s Medi-Cal program. Either way, you’ll have great health coverage.
CoveredCA.com is sponsored by Covered California and the Department of Health Care Services, which work together to help Californians get the coverage and care that are right for them.
When will my coverage start?
Coverage will usually start on the first day of the month following plan selection (for example, if you selected a plan on Dec. 31, your coverage would start on Jan. 1).
For the birth or adoption of a child, or acceptance of a child into foster care
For the birth or adoption of a child, or acceptance of a child into foster care, you can choose to have coverage start on:
- The first day of the month following the birth, adoption, or placement in your foster care of a child, or
- The date of the birth, adoption, or placement in foster care, or
- The first day of the month following plan selection.
In addition, you can choose a different date (or a different date may apply) for the following qualifying life events:
- Appeals decisions:
- The date specified in the appeal decision, or
- First day of the following month.
- Birth, adoption, placement for adoption, placement in foster care or child support, or other court order:
- At the enrollee’s request or request of the authorized representative:
- On the date of the event; or
- On the first day of the month following the event; or
- On the first day of the month following plan selection.
- At the enrollee’s request or request of the authorized representative:
- Court order causes applicant to gain a dependent or become a dependent:
- At the enrollee’s request:
- Effective date of the court order, or
- First day of the month following plan selection.
- At the enrollee’s request:
- Death of an enrollee or dependent:
- Coverage for the remaining household members begins the first of the month following QHP selection.
- End of employer contributions or government subsidy to existing COBRA continuation coverage:
- On the first day of the month following the triggering event; or
- On the first day of the month following plan selection (if plan selected after the date of the triggering event).
- Erroneous enrollment/non-enrollment in a Covered California plan due to an officer, employee or agent of the exchange or HHS, its instrumentalities, a qualified health plan issuer (QHP), or a non-exchange entity providing enrollment assistance; or
- Violation of contract by a Covered California plan; or
- Exceptional circumstances, including hardship, change regarding an exemption; or
- Natural or human-caused disaster resulting in a declared state of emergency in California; or
- National public health emergency or pandemic; or
- Determined ineligible for Medi-Cal or CHIP after end of Covered California’s open-enrollment period (after applying during Covered California’s open-enrollment period or special enrollment period); or
- Error causing decision to purchase a QHP through the exchange:
- An appropriate date decided by Covered California (including a retroactive date), on a case-by-case basis
- Loss of Minimum Essential Coverage; or
- Loss of enrollment in a non-calendar-year group health plan or individual health insurance coverage; or
- Newly ineligible for qualifying coverage in an eligible employer-sponsored plan:
- Whichever date is later:
- First day of the month following plan selection, or
- On the first day of the month following the loss of coverage — (if the applicants know that they will lose coverage in the future).
- Whichever date is later:
Once I’m enrolled, what do I do next?
After enrolling, new members will receive a welcome letter and a brochure from Covered California. You will also get an enrollment package and membership ID card from your health insurance company.
You can use services covered by your health insurance plan starting the next month after you make your first payment, even before your membership ID card has arrived.
If you haven’t already, be sure the provider (a doctor or other health service provider) you want to see is participating in the health plan network you have selected. If you visit the provider before you receive your membership ID card, you may be asked to sign a statement agreeing to pay for the services if you cannot prove you have health insurance.
The provider may later send you a bill (a “claim”) for the care. It is likely that by the time you get a bill or claim from your provider, you will already be entered into your health insurance company’s system. Once you have your membership ID card, simply contact your provider, provide them your membership ID card number and ask to have the bill resubmitted directly to your health insurance company.
Will I get a membership ID card?
If you are newly enrolled in a health insurance plan through Covered California, you will receive a membership ID card from your health insurance company after it receives your first payment.
If you were covered one year and you renewed and kept the same health insurance plan, you can keep your current card for the following year. If you change coverage, such as metal tiers or health insurance companies, your health insurance company will send you a new welcome packet and health insurance card after receiving payment.
Submitting Documents to Confirm Your Eligibility?
Covered California compares the information you enter on your application with government data sources or information you have provided before. If the data is inconsistent, we ask you to submit documents to confirm the new information. (Please check the Link of Covered California website )
Need Help In Application ?
Get free and confidential help right away.. Please Call Us on (559) 575-0007 oe email kathy@greatwishllc.com
Didn’t Receive a Bill From Your Insurance Company
Questions about premium bills, payment due dates and costs associated with doctor visits or other services should be directed to your health insurance plan or dental plan. Check the link Below Health Insurance Contact
Qualifying Life Events
What is the difference between Covered California and Medi-Cal?
Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income. Covered California is the state’s health insurance marketplace where Californians can shop for health plans and access financial help if they qualify for it. Health plans available through Medi-Cal and Covered California both offer a similar set of important benefits, called essential health benefits. You can apply for both programs at the same time when you use our single application.
