Covered California

Covered California™ is the state’s destination for quality, affordable health care. A part of the national health care law , Covered California is a program from the state of California where qualified lawful residents and their families can compare quality health plans and choose the one that works best for their health needs and budget.

Enrollment Deadlines

Enrollment in health plan through Covered California begins Nov 1, 2020 and continues until Jan 31, 2021. You must purchase health insurance during this open-enrollment period in order to obtain coverage through Covered California.

Financial Assistance

Based on your household income, your family may qualify for a tax credit to help pay for health coverage or low-cost or no-cost plans through Medi-Cal. To learn if you qualify, see the chart below.

All numbers listed above are estimates. For larger households, please visit the Shop and Compare tool at CoveredCA.com to find out if your family qualifies.

Benefit

The health plans that will be offered through Covered California are guaranteed to provide basic levels of coverage and provide consumer protections,including the 10 categories of essential health benefits:

Ambulatory patient care
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance abuse disorder treatment
Prescription drugs
Rehabilitation and habilitation services and devices
Lab services
Preventive & wellness services and chronic disease support
Pediatric services, including dental and vision care

Special Enrollment

To enroll in coverage outside of Covered California’s open-enrollment period, consumers must experience a “qualifying life event.” Many different types of qualifying life events are described in the chart below.

Got married / Divorced
Had a baby / Adopted a child
Lost your employer-sponsored coverage
No longer eligible for student health coverage
Lost Medi-Cal Coverage
COBRA Coverage Exhausted
Moved outside your plan’s coverage area
Turned 26 years old
Turned 19 years old
Became a US Citizen or a lawful presence
Other qualifying life event

Coverage Category	Bronze	Silver	Gold	Platinum
Deductible	$6,300 – Medical $500 – Drug	$4,000 – Medical $300 – Drug	$0	$0
Annual Wellness Exam	$0	$0	$0	$0
Primary Care Bisit	$65 – First 3 visit	$40	$35	$15
Urgent Care Visit	$65 – First 3 visit	$40	$35	$15
Emergency Room Facility	40% after deductible amount is met	$400	$350	$150
Generic Drugs (Tier1)	$18 after pharmacy deductible amount is met	$16 after pharmacy deductible amount is met	$15 or less	$5 or less
Maximum Out of Pocket for Individual	$8,200	$8,200	$8,200	$4,500
Maximum Out-of-pocket for Family	$16,400	$16,400	$16,400	$9,000