Covered California
Improved Benefits for Covered CA Enrollees
The American Rescue Plan of 2021 provides billions of federal dollars to reduce premiums for people who buy their health insurance through Covered California. The aid expands a federal tax credit only for those who buy individual or family policies through Covered California and other state exchanges. Families could save a lot of money - an average of $180 per household each month - by switching to a Covered California health plan. Some families who earned too much to qualify for Covered California will now be eligible, as well.
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Need Help?Contact an advocate or staff member at a Family Resource Center for support with non-medical needs such as food, clothing, shelter, parent education and navigating social services. A full listing of Family Resource Centers in San Luis Obispo County can be found here: https://sloparents.org/slo-frc-directory/
Health NavigationThe SLO County Public Health Nurse Navigator Program helps SLO County residents get access to the health care they need.
If a resident doesn't have health insurance, needs help finding a provider, or something else related to navigating the health care system, contact the Health Care Access and Navigation staff for a free, confidential evaluation at 805-781-4838. Learn more and find a Contact Form here. |
Enrollment Assistance
To locate a local Covered CA-certified insurance agent, click here. Certified Insurance Agents may have specialized knowledge about which providers and medications are covered by each plan that would be helpful for people with more complex medical situations. This service is free of charge.
The Covered California online enrollment system is available at www.coveredca.com. Covered California and Medi-Cal can both be applied for at this website. After the client enters information, they find out whether they qualify for Medi-Cal or Covered California. Anyone can determine their eligibility in advance at: https://apply.coveredca.com/lw-shopandcompare/.
For more local enrollment assistance, click here.
The Covered California online enrollment system is available at www.coveredca.com. Covered California and Medi-Cal can both be applied for at this website. After the client enters information, they find out whether they qualify for Medi-Cal or Covered California. Anyone can determine their eligibility in advance at: https://apply.coveredca.com/lw-shopandcompare/.
For more local enrollment assistance, click here.
Qualifying Income Levels
Access to sliding scale health insurance is available through Covered CA for adults with income levels between 138% and 600% of the Federal Poverty Level (FPL) and children with income levels between 266% and 600% of the FPL (adults and children with incomes below these amounts are eligible for Medi-Cal coverage). The sliding scale cost is covered by advance premium tax credits. Eligibility for tax credits is determined using last year's FPL. Use the Covered CA website to determine eligibility: https://apply.coveredca.com/lw-shopandcompare/.
Both individuals and families can purchase sliding-scale insurance through Covered CA. For example, if a child is covered by Medi-Cal, the parents can purchase insurance through Covered CA. Or if an adult has insurance through their employer, insurance for their child can be purchased through Covered CA if the employer does not offer dependent coverage.
Families with incomes above the maximum can also purchase policies through Covered CA or through an independent broker but will not receive subsidies.
Both individuals and families can purchase sliding-scale insurance through Covered CA. For example, if a child is covered by Medi-Cal, the parents can purchase insurance through Covered CA. Or if an adult has insurance through their employer, insurance for their child can be purchased through Covered CA if the employer does not offer dependent coverage.
Families with incomes above the maximum can also purchase policies through Covered CA or through an independent broker but will not receive subsidies.
Additional Information
Open Enrollment takes place each year during the fall. Typically, if you do not have a "qualifying life event" you must wait until open enrollment to enroll in a Covered California Plan. In 2021, however, a special enrollment period for anyone who is uninsured is taking place for the rest of the year. Medi-Cal enrollment is always open year round.
Special Enrollment is always open for people who have a qualifying life event, to enroll in a Covered CA plan or make changes to their current plan. Coverage begins after completing the application process. For information on qualifying life events: www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/. In 2021, a special enrollment period for anyone who is uninsured is taking place for the rest of the year.
Medi-Cal: Remember that Medi-Cal is open all year and may be retroactive for medical services used in the prior three months. Remind clients to respond to any re-determination letter they have received from Medi-Cal to maintain their Medi-Cal status.
Pediatric Dental coverage is included in Covered CA plans; families should ask their health insurance provider for more information.
Pregnant Women: There are several public and subsidized insurance options for pregnant women, regardless of immigration status. Read more here: www.coveredca.com/individuals-and-families/getting-covered/pregnant-women.
Special Enrollment is always open for people who have a qualifying life event, to enroll in a Covered CA plan or make changes to their current plan. Coverage begins after completing the application process. For information on qualifying life events: www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/. In 2021, a special enrollment period for anyone who is uninsured is taking place for the rest of the year.
Medi-Cal: Remember that Medi-Cal is open all year and may be retroactive for medical services used in the prior three months. Remind clients to respond to any re-determination letter they have received from Medi-Cal to maintain their Medi-Cal status.
Pediatric Dental coverage is included in Covered CA plans; families should ask their health insurance provider for more information.
Pregnant Women: There are several public and subsidized insurance options for pregnant women, regardless of immigration status. Read more here: www.coveredca.com/individuals-and-families/getting-covered/pregnant-women.