Frequently Asked Questions
Open enrollment happens once a year during the fall. Open enrollment for 2017 coverage is over, but individuals with special qualifying life events can enroll at any time of the year. Medi-Cal enrollment is also year-round. Medi-Cal and Covered California use the same application. After you enter your information, you will find out whether you qualify for Medi-Cal or Covered California.
The best way to get a quick estimate of the price you would pay is to use the Shop and Compare Tool. The price is based on your estimated income for the coverage year, your ZIP code, your household size and your age. If you are a low- or moderate-income Californian, you may get help buying insurance from Covered California through monthly subsidies that lower your premium costs so that you pay less for top-quality, brand-name insurance. Learn more about who qualifies for a subsidy.
All Covered California health insurance plans come with children’s dental coverage embedded in the health plan. In addition, Covered California offers optional family dental plans that provide dental benefits for adults. Learn more on the Dental Coverage page.
The federal government has not committed to providing ongoing funding for certain health care costs for Covered California enrollees, requiring Covered California to take steps to ensure stability and good health coverage through 2018. The cost-sharing surcharge will increase premiums for those with Silver-tier coverage, but most consumers will see their financial assistance rise to help cover the increase, meaning no significant impact on a consumer’s monthly cost.
For 2018, certain federal funds that have supported Covered California enrollees’ access to affordable care in recent years are now in jeopardy, but it will not affect the quality of the health insurance consumers received through Covered California. In 2018, a cost-sharing reduction surcharge will be added to rates for consumers with Silver plans. It will raise the price that some of these consumers pay for their health insurance, but most consumers will not see a significant change in the net price of their monthly premium because their financial help will increase as well. Otherwise, Covered California will keep offering the same affordable, quality health coverage it has offered since 2014.
Covered California has a feature that lets you add providers (doctors, hospitals, and pediatric dentists) to your search while you shop for a health plan.
First, enter your household information in the Shop and Compare Tool, and then answer two questions about your health care needs. Then you will see a search tool that lets you select up to five providers. You can search for providers by name. Once you have made your selections, click the “View Plans” button to see the health plans available to you. In each plan’s description, either a green or a red icon will be displayed next to the provider’s name, indicating whether the provider is included in that health plan’s provider network.
Before enrolling in a plan, it is always a good idea to confirm with providers that they accept your plan of choice.
While you are shopping for a health plan through Covered California, you can view a list of in-network doctors for each plan. This is the best way to get a quick overview of the doctors near you.
Start by using the Shop and Compare Tool. Once you are on the page displaying your health plan options, click the “View Detail” button in the bottom-right corner of a plan’s description. There is a feature on this page that lets you see the names of all the doctors in your area. In the “Doctors and Facilities” section, select the “View Map” button to see the location of doctors included in the plan.
For a more detailed search of providers included in a health plan — including pharmacies, medical equipment, urgent care centers, mental health providers and alternative medicine — select the “Provider Directory” link on the left-hand side of the “View Health Plan Details” page to be taken to the health plan’s website.
Both directories are good tools for Covered California consumers and every effort is made to keep them up to date, but you should verify with the providers of your choice that they accept the plan before enrolling and seeking care.
All Covered California health insurance plans include children's vision care. In addition, Covered California now offers consumers a direct pathway to quality vision coverage. Learn more on the Vision Coverage page.
Depending on the plan you select, you may be able to pay your first bill when you apply for coverage online. All future bills must be paid directly to the plan, not through your Covered California account.
If you do not pay your first bill online, your health insurance company will send you a bill about two weeks after it receives your application or renewal. The payment due date will be printed on the bill. Please send your payment to your health insurance company before the deadline. If you pay your bill by mail, be sure you send it in time for the insurance company to receive your payment by the payment date printed on the bill. Your health insurance company also may accept payment through the phone or online, which would be faster than mailing your payment. Contact your health insurance company or visit the Paying Your Premium page for more information about payment options.
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. Learn more about what to expect on the Using Your Plan page.
If you were covered in 2016 and you renewed and kept the same health insurance plan, you can keep your current card for 2017. 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.
If you have already applied, you do not need to apply again. Medi-Cal is processing your application as quickly as possible. Because of the large number of Medi-Cal applications received, processing could take longer than expected, and proof of certain information is required in order to complete each application. If you need immediate assistance or have a specific question about your application, contact your county human services agency for in-person assistance with your application. You can also find more information within the Medi-Cal section of this website and on the California Department of Health Care Services’ website.
You’ll have a choice of buying insurance from at least two but as many as six private insurance companies, depending on where you live. The vast majority of Covered California consumers have access to insurance plans from at least three different companies. Each plan offers products in multiple metal tiers (or coverage levels), which vary whether you want to pay more for your monthly premium and less when you use care, or pay less for your premium and more when you use care. Consumers with limited incomes may learn they qualify for Medi-Cal.
To see which brand-name insurance companies offer plans in your area, use our Shop and Compare Tool.
View the Using Your Plan page in the Members area to learn about all of the benefits of being enrolled and how to use your plan.
No. Covered California is where Californians can get brand-name health insurance under the Patient Protection and Affordable Care Act and see if they qualify for financial subsidies from the federal government to help them pay their monthly premiums. Visit our About Covered California page to learn more.
Yes. Visit the Covered California for Small Business section of our website to learn about the benefits for small businesses and their employees.
For instructions on how to create an online account, visit the Members area.
You can reset your password by clicking "Account Sign In" and then clicking the "Forgot Password?" link. Enter your user name. After you correctly answer your security questions, you will be able to enter a new password. If you do not remember the answers to your security questions, it is best to leave them unanswered and call the Service Center at (800) 300-1506. A Service Center representative can help reset your password.
Here are the rules for creating a password:
- You cannot use words found in a dictionary or names.
- Your new password cannot be one that you have used within the last 24 passwords.
- Your password must have at least eight characters and have no more than 16 characters.
- Your password must start with a letter and include:
- At least one uppercase letter (A-Z).
- At least one lowercase letter (a-z).
- At least one number (0-9).
- At least one special character (#, $, %, etc.).
You can reset your username by clicking "Account Sign In" and then clicking the "Forgot Username?" link.
Visit the Covered California Notices to Consumers page.
If you have not selected a health plan, the best way to find out if a doctor is in a plan you are considering is to look at your options in Shop and Compare and follow the “View Directory” link for a specific plan to see the plan’s provider directory on the insurance company’s website. If you have a specific doctor in mind, it’s also a good idea to call that provider’s office and ask about the insurance it accepts. To learn more about prescription drugs and formularies, visit our Prescription Drugs page.
If you have already selected your health plan, go to your health insurance plan’s website and look up your provider (doctor, hospital, etc.). Doing this prior to making an appointment can help you verify that your provider participates in your chosen plan's provider network. Learn more on the Using Your Plan page.
A comprehensive list of free preventative care available in all health plans through Covered California can be found in the Members area.
Most Americans are required to have health insurance under the Affordable Care Act. If you choose to remain uninsured, you may face a tax penalty. Learn more about the penalty for remaining uninsured.
Welcome to Answers
- What is Covered California?
- What Kind of Health Insurance Does Covered California Provide?
- How Is the Affordable Care Act Changing Health Insurance?
- How Does Covered California Make Insurance Affordable?
- How Can Covered California Help People Under 30?
- What is Special Enrollment?
- Welcome to Your Health Plan
- Health Terms Defined