Covered California Notices to Consumers

Welcome to the Covered California community! Once you have enrolled in a health plan, you will receive notices from us to maintain important communication with you. We want to make sure that your information is up to date to help you stay covered. Below, we will review some examples of notices that you, as a consumer, may receive from us. Please stay connected with us by promptly responding to these letters when requested. You can learn more about these notices by clicking on the notice titles below.

notice logo

Here are some of Covered California’s most frequently sent notices:

Eligibility Determination Notice

If you submitted an application for health coverage, you will receive an Eligibility Determination Notice. It tells you which program you and your family may qualify for, such as Medi-Cal, the Medi-Cal Access Program, the County Children’s Health Initiative Program or a Covered California plan.

This is the first page of the notice.

Eligibility Determination Notice

If this notice says that you or someone in your household qualifies for coverage through Covered California, you must pick a health plan. Your coverage will start after you pick a plan and pay your first month’s premium. If you have not already picked a health plan, please log into your account on CoveredCA.com. You can also call the Covered California Service Center at (800) 300-1506 for help.

Document Reminder Notice

When you apply for health coverage, Covered California checks electronic sources to confirm the information in your application. Most times, your information can be confirmed automatically. But sometimes we need more information and we ask consumers to mail, fax or upload their documentation.

If you receive this notice, you will see a partial list of document types that you can send to verify your information. If you do not have the documents suggested on that list, you can also check the full list of acceptable document types that you can send if we ask you to confirm information.

The notice has instructions about how to upload the requested documents to your Covered California online account. You may send copies of the documents via fax or mail if you prefer. Please upload or send the requested documents to verify your information by the date indicated on your notice.

All of your information will be kept confidential and secured. The documents you submit will not affect your citizenship or immigration status and will not affect an application for U.S. permanent residency or citizenship. None of the information is used for immigration enforcement purposes.

If you have already submitted your documents:

  • It is possible that Covered California needs additional documents from you or that we were unable to verify your information with your previously submitted documents.
  • Please resend documents, making sure that they are on the list of acceptable documents.

If you would like help, please call the Covered California Service Center at (800) 300-1506.

Transition Notice

When you tell us new information about your household, such as a new family member, an increase or loss of income, or a move to a new address, you could qualify for a different health coverage program. When that happens, you will receive an Eligibility Determination Notice from Covered California (described above) telling you that you no longer qualify for Covered California and telling you which new program you qualify for, such as Medi-Cal, the Medi-Cal Access Program or the County Children’s Health Initiative Program. You will receive a separate welcome notice from your new program.

If you are a Covered California member and your new information results in a transition to Medi-Cal, you will receive a notice about this change. It explains that your Covered California plan will remain in effect until Medi-Cal makes the final determination on your case. The notice will look like this:

Transition Notice

Notice Requesting Documents to Verify Your Qualifying Life Event

Some consumers who apply for Covered California coverage in a special-enrollment period are asked to submit verification of their qualifying life event. If you receive a letter asking you to submit documents for your qualifying life event, visit the website provided in your letter or call the Covered California Service Center at (800) 300-1506.

Renewal Notice

You will get this notice toward the end of each year to tell you that your Covered California health plan is coming up for renewal. It comes in a light green envelope.

This is the first page of the notice.

Renewal Notice

When you renew your insurance, you will be able to:

  • Let Covered California know if any of your application information has changed.
  • Find out if you qualify for a different program.
  • Find out if your costs have changed.
  • Change your current health plan.

If you do not actively renew your insurance and tell us new information or make changes to your account, Covered California will automatically re-enroll you or members of your household into your current health plan. We will renew your insurance using the most recent household size and income information you gave us.

Form 1095-A

At the beginning of each calendar year, you will receive a Form 1095-A to use when you file your taxes.

Form 1095-A

Your Form 1095-A shows the amount the Internal Revenue Service paid to your insurance company to help you with the cost of your health coverage. The amount paid was based on the income information and household size you provided. If your income changed during the year, you may have paid too much or too little for your health coverage.

If you enrolled in a health plan through Covered California but did not receive premium tax credits, you will still receive a Form 1095-A from Covered California to show you what months you had health insurance. You will use this form when you file taxes.

If you do not receive a Form 1095-A from Covered California, or if you disagree with the information shown, or you need to request a correction to the form, please complete the dispute form or call the Covered California Service Center at (800) 300-1506.

If you would like more help understanding your notices, please contact the Covered California Service Center at (800) 300-1506, or find help near you.