With additional health plans to choose from, increased access to care, and even more financial help available, getting health insurance has never been this affordable.
Buying health insurance for 2024? It’s a good idea to get up to speed on the new rules and regulations, and how to get or stay covered. So, here’s what you need to know.
More Health Plans to Choose From Through Covered California
Covered California’s pool of quality health insurance companies continues to grow, offering even more affordable brand-name plans for you and your family. The Inland Empire Health Plan joined Covered California, bringing more choices to consumers in the Riverside and San Bernardino counties. Aetna CVS Health, which first joined us in 2023, will begin offering plans in Contra Costa and Alameda counties. Similarly, Health Net will start offering coverage to residents in Imperial County. As a result, we will have a total of 12 health insurance companies across the state to choose from. All residents will have at least two options with over 90% of consumers having four or more insurance providers to pick from.
More Financial Help Through Covered California
Beginning 2024, state taxes collected under the individual mandate will be used to help further lower the cost of health insurance for those that enroll in Covered California. This along with financial help that began under the Affordable Care Act and that was enhanced by the American Rescue Plan and then extended further by the Inflation Reduction Act will make quality health insurance more affordable than ever before. Since 2020, if you live in California, having health insurance is the law, and going without could cost a family of four, at minimum, a penalty of $2,700, come tax time.
An example of these savings is our Enhanced Silver Plans. Starting in 2024, 650,000 Californians will qualify for additional state subsidies known as cost sharing reductions that will not only eliminate their deductibles but also decrease their out-of-pocket expenses on prescriptions, emergency care, and doctors visits. Some may even see a decrease in their monthly premium. Nearly 90% of all enrollees will receive financial help with many paying $10 or less a month for their health insurance premium.
Medi-Cal for All, Regardless of Immigration Status
Starting 2024, all Californians, regardless of immigration status, can enroll in Medi-Cal if their income qualifies. Over the last few years Medi-Cal has been expanding coverage to include undocumented adult immigrants. Californians under the age of 26 have received this coverage since 2020. Starting January 1st of 2023, these benefits became available to eligible adults ages 26 to 49. And starting this year, Medi-Cal is extended to all qualifying low-income adults 50 years and older. This is just one of many ways the state continues to invest in the overall health equity of its residents.
More Access to Healthcare Services
Consumers affected by limited access to providers, and the unanticipated out-of-network costs associated with that, will soon have more options. Beginning in 2024, health plans must offer at least one treatment center for substance use disorders and one mental health facility in every county where available in the health plan’s service area. These are known as Essential Community Providers, which already include free clinics, children’s hospitals, family planning clinics, facilities run by Indian tribes, rural medical centers, and centers dedicated to chronic conditions such as HIV/AIDS or cancer. It also includes providers that serve low-income consumers or those in underserved areas. The addition of these behavioral health care centers not only further expands what consumers have access to but also the choices they have when picking a provider.
More Time to Get Covered After Losing Medi-Cal, CHIP
Starting January 1st, Californians who lose their coverage through Medi-Cal or the Children’s Health Insurance Program (CHIP) will have more time to enroll in Covered California. The special enrollment period to apply is now 60 days before the loss of coverage and up to 90 days after that coverage has ended. If you lost your Medi-Cal, you can learn more about staying covered here.
No More Surprise Out-of-Pocket Costs
Navigating the cost of health insurance can be a tricky process. It often leaves consumers guessing how much a medical procedure, test, or treatment will cost them after co-pays and deductibles. But now health insurers and employers that offer health plans must provide online calculators for a range of services and drugs. Consumers will enter the information and the calculators produce real-time estimates of a patient’s out-of-pocket cost. And the results are personalized, computing how much of an annual deductible patients still owe and the out-of-pocket limit that applies to their coverage. The amount the insurer would pay if the service were out of network must also be shown.
That said, there is no guarantee the exact final cost will be shown. There can be unforeseen factors during the course of treatment which may include the need for additional services. But consumers will have at least more information than before to make informed decisions about their health.
New Out-of-Pocket Maximums for 2024
The out-of-pocket maximum is the upper limit of how much you have to pay for covered services in one year. It applies to copayments, deductibles, and coinsurance for in-network care and services. Once you meet this amount, your health plan will pay 100 percent of the costs for covered benefits. For 2024, the out-of-pocket limit is $9,450 for an individual and $18,900 for a family — up from $9,100 and $18,200, respectively, in 2023.
Tax Penalties Increase for Not Having Health Insurance
In California, people must have coverage or pay a tax penalty (unless they qualify for an exemption). The penalties for not being insured generally increase each year adjusted for inflation. For tax year 2023, Californians without coverage for the entire year will likely pay a minimum penalty of $900 per adult and $450 per dependent child under the age of 18. A family of four who goes the whole year with no coverage could owe a minimum of $2,700 come tax time. You can use the tax penalty calculator to estimate what you may owe if you don’t have health insurance.
Street Medicine Approved for Treating the Homeless
The Biden administration has made it easier for doctors, nurses, and other providers to treat the unhoused, from creekside encampments to freeway underpasses, marking a fundamental shift in how — and where — healthcare is delivered. This is the first time the federal government has recognized the streets as a legitimate place to provide care, affecting the homeless, low-income, disabled, and older populations.
This expansion of care will greatly impact California’s more than 170,000 unhoused residents who often lack the means and mobility to visit – or even locate – a doctor who will accept them. On average, this population dies three decades earlier than their peers, and usually from preventable and treatable conditions. Meanwhile, the healthcare costs for the homeless are five times the national average, due to an over reliance on the emergency room for routine care. This change in policy removes those hurdles and makes healthcare completely patient-centered, with doctors and nurses coming to them.
Street medicine is different from mobile clinics involving a parked trailer and a team facilitating such things as HIV testing. Street medicine meets unsheltered people right where they are living.
Employees Get Access to More Affordable Healthcare
Employees who aren’t offered affordable health insurance through their job may get financial help for coverage when signing up for a plan through Covered California. What is considered affordable health insurance is set by the IRS and changes every year. For 2023, that rate was set to 9.12% of an employee’s household income, and for calendar year 2024, it will be 8.39% – the lowest it has been since the Affordable Care Act was implemented. That means, for 2024, if the lowest-cost employee-only plan offered to you by your employer is more than 8.39% of your household income, you can apply for a plan with financial help through Covered California. However, if that same plan meets the affordability threshold for the employee but costs more than 8.39% to cover additional family members, those family members may qualify for financial help themselves when they sign up for a plan through Covered California.
We’ve Got You Covered!
Just like buying health insurance, your life and your family’s needs may change year to year. We are here to help. Find out quickly and easily just how much financial help you could get to pay for health insurance. Explore your options now and get the coverage you need —or contact us at any time.
What has changed in health insurance in previous years: