As a resident of California, you should be familiar with the name Covered California. It offers a wide range of health plan choices, and you can expect to find one that fits your budget and requirements. Furthermore, you have the convenience of comparing different health plans while accumulating data on whether you are eligible for financial help.
For the unversed, if you qualify for federal tax credits, it can drastically reduce the cost of your monthly premiums. In this article, we cover the vital aspects that should make it easier for you to avail of the best Covered CA health insurance plan.
Eligibility criteria for Covered California
You must a citizen of the USA or a lawfully present immigrant. For your convenience, Covered California offers the FPL chart; you can evaluate your percentage of FPL. Once you know the score, you can avail of the Shop and Compare tool for determining various costs of plans in your region. Furthermore, it will assist in finding if you qualify for financial help. We explore the aspects in detail below.
The enrolling procedure
First, you can explore your options, starting at the “Shop and Compare” option, as mentioned above. Then, you can compare the plans that best suit your requirements, and add the same to your shopping cart. Keep all the necessary documents ready for submitting your application. these documents include your income information, ID, proof of citizenship, and the Social Security Number, and Zipcode.
Make your initial payment online. If you qualify for Medi-Cal you will receive the said intimation. That is it, you along with your family is now covered.
Help related to premium and cost-sharing reductions
At Covered California, you can expect availing two forms of help for paying the cost of coverage, premium assistance, and cost-sharing subsidies. The former is a tax credit that can help reduce the cost of monthly premiums. The cost-sharing subsidies aim at reducing the out-of-pocket costs. The details of each of these are described below in brief.
For availing the premium assistance feature, you must not be eligible for other public healthcare coverage. Additionally, you must not have access to affordable, minimum value health insurance via an employer.
Your annual household income should be within 138 percent and 400 percent of the federal poverty level (FPL) for qualifying in specific financial programs like Medi-Cal. The FPL is revised each year by the federal government.
When availing healthcare facilities, often you have to deal with specific out-of-pocket costs. If you qualify for the premium assistance and have an annual household income of up to 250 percent of the FPL, you stand to qualify for cost-sharing reductions. Soon after you fill-up the application for Covered California, you can identify, if you qualify for it. All the co-payments, coinsurance, deductibles, and your expenses will become much lower.
Primarily, it consists of two plans, a Silver-level plan, and Enhanced Silver plans. By using the former, the cost-sharing reductions apply automatically when you use it for health care programs.
Know how to use premium assistance
After qualifying for premium assistance, you should understand how and when to use it. Either you can use it monthly or you can receive it when you file the taxes. Here are the details.
Using premium assistance monthly
You can prefer getting the full amount of your health plan premium for lowering your monthly payments of the premium. The government will directly pay the tax credit to your selected insurance company, every month. The remaining cost of the premium you must pay out of your pocket.
Receive it when paying taxes
Alternatively, you have the option of paying the full price of your premium payment every month. Following this, you can receive the full premium assistance amount in the form of a tax refund, during the time of filing the tax return.
Medi-Cal and Income Changes
In situations, where you do qualify for a Covered California health plan along with premium assistance, and suddenly you see a dip in your income, you will have automatically become eligible for Medi-cal. The said program serves low-income individuals as you may know. When this happens, you no longer require repaying the premium assistance you received. However, you must remember to report the income changes within a month.
The responsibility of reporting the said changes solely depends on you, and it will help you to switch programs. You can find a “Report a Change” button in the Covered California online enrollment system. Use this button to update your latest income stats.