How to Sign Up for ACA Health Insurance in California

Posted on 02/02/23 by Andrew Soergel, Elissa Chudwin

En español | Most Californians are eligible to buy health insurance through Covered California, the state’s Affordable Care Act (ACA) marketplace, which opens Nov. 1, 2023, for 2024 health insurance coverage. 

If you experience a qualifying life event — such as the birth of a child, a move, a marriage, a divorce or the loss of your employer-provided health insurance — you may be able to enroll or change your coverage outside of open enrollment during a special enrollment period.

Most people enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households that qualify for them. Every household that pays more than 8.5 percent of its income qualifies for federal tax credits to help them afford health insurance. These enhanced subsidies are available through 2025.

Before the 2021 law, such tax credits were only available to people making less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.

  • Most Californians, including non-U.S. citizens with worker or student visas, are eligible to buy health insurance through Covered California, regardless of whether they are currently insured. 
  • You may also qualify for Medi-Cal, the state’s Medicaid plan, which offers free or low-cost coverage to low-income people and families and to those who live in skilled nursing facilities or have certain disabilities. Non-U.S. citizens without documentation can get some Medi-Cal coverage if they are pregnant or are 18 or younger. 
Covered California LA Launch Event

  • Covered California opens on Nov. 1, 2023, for 2024 health insurance coverage.

  • You can enroll during a special enrollment period if you experience a qualifying life event, but you usually only have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances.

You apply for coverage and choose your plan at the same time. Once you’re approved for a plan, you’ll need to pay your first monthly premium for your coverage to begin. You can pay online or ask to receive a bill in the mail, which should arrive in about two weeks. To apply and enroll: 

  • By phone: Submit your name and contact information online and a certified insurance enroller will call you back, usually within 15 minutes during normal business hours. You can also call Covered California’s service center at 800-300-1506. 

You can also call Covered California’s service center (800-300-1506) or visit a local enrollment center for help with exploring plans, to ask questions and to help determine if you qualify for financial assistance. 

Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family. 

If you qualify for Medi-Cal, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income. 

All Covered California plans cover 10 “essential” benefits, including: 

  • Emergency services and hospitalization 
  • Pregnancy, maternity and newborn care 
  • Mental health services (including counseling) 
  • Chronic disease management
  • Pediatric care 
  • Prescription drugs 

Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family. 

All Covered California plans cover basic dental services for children, including cleanings and exams. But adults who want dental coverage must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs. 

Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income qualifies for federal tax credits for insurance premiums through 2025. 

According to Megan O'Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have seen average annual savings of more than $950.

Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for out-of-pocket expenses such as deductibles and copays. You must enroll in a Silver-level plan to get this assistance. 

Covered California’s plans are organized into four categories: 

  • Bronze plans have the lowest monthly premiums and the highest deductibles and copays, and they cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury. 
  • Silver plans have moderate monthly premiums, deductibles and copays. They cover 70 to 94 percent of care costs, depending on whether you qualify for a basic plan or an Enhanced Silver plan for lower-income households. They’re the only plans eligible for cost-sharing subsidies.
  • Gold plans have higher monthly premiums and lower deductibles and copays. They cover roughly 80 percent of care costs. 
  • Platinum plans have the highest monthly premiums and the lowest deductibles and copays. They cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums. 

Covered California’s Shop and Compare tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance. Californians 29 and younger can also apply for a minimum coverage or catastrophic plan offering low premiums and covering three doctor visits or urgent care visits per year. 

If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to Covered California. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.12 percent of your household income for individual coverage to qualify for the tax credits. 

If you lose coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), you may be able to sign up for a Covered California plan during a 60-day special enrollment window. Try to apply and select your plan before your COBRA coverage ends to make sure there's no gap in coverage. If you’re not sure about whether making this switch makes sense for you, you can ask for free advice from a certified enroller or insurance agent

If you already have a marketplace plan and want to adjust your coverage, you’ll need to wait until the renewal period opens this fall. If you don’t take action during the renewal period, you’ll automatically be reenrolled in your existing plan. 

That depends. Major insurance providers, including Anthem Blue Cross and Kaiser Permanente, offer Covered California plans, but not all doctors accept them. You can talk to your primary care physician or use the Shop and Compare tool to see whether a certain doctor or practice will accept a marketplace plan. 

It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs, depending on age, income and disability, or caregiver status. Such families may choose to enroll as “mixed-program families” and still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted. 

This guide was updated on Feb. 2, 2023, with more information about open enrollment.

    This story is provided by AARP California. Visit the AARP California page for more news, events, and programs affecting retirement, health care, and more.

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