June 30, 2015
Getting California Covered:
California was the first state in the nation to enact legislation to implement the Affordable Care
Act (ACA). Covered California was created to develop our state's organized marketplace where legal
residents of California can buy health coverage. Under ACA, insurance companies can no
longer deny coverage due to sickness or a pre-existing health condition and must provide the mandated 10 essential health benefits.
Who will Be Covered:
As of January 1, 2014, about 2.6 million Californians will qualify for health coverage with federal financial
assistance, and an additional 2.7 million who do not qualify for assistance will still benefit from
guaranteed coverage through Covered California or from an insurance company in the
individual market. An estimated 2.3 million California residents will enroll in a health plan
through Covered California by 2017. In addition, California expanded eligibility for Medi-Cal to
include childless adults up to 138% of federal poverty level.
About the Affordable Care Act:
The Affordable Care Act created a number of ways to help reduce the cost of insurance and
encourage uninsured people to get covered. The federal law provides financial assistance to
help individuals and small business pay for health insurance. The law also requires that most
people over the age of 18 have health insurance or pay a penalty starting in 2014. People that
already have affordable health insurance do not need to take any action, unless their health
coverage status changes.
10 Benefits Covered:
All health plans, whether offered by Covered California or in the private marketplace must
cover ten benefits called Essential Health Benefits, beginning in January 2014. These include
services like doctor visits, hospitalization, emergency care, maternity care, pediatrics,
prescriptions, medical tests, mental health care and others. Plans must cover preventive care
services like mammograms and colonoscopies with no out-of-pocket cost to consumers. All
newly sold health plans are required to offer these basic benefits.
The Health Insurance Marketplace:
On October 1, 2013, Covered California will open the marketplace and begin enrolling eligible
Californians for health coverage that will begin January 1, 2014. Legal residents of the state
of California who do not have affordable health insurance through their employer or are not
eligible for another government program can purchase health insurance through Covered
California. Open enrollment for coverage beginning Jan. 1, 2014 begins October 1 and ends
March 31, 2013. The subsequent open enrollment period for coverage beginning Jan. 1, 2015
begins Oct. 15, 2014 and ends Dec. 7, 2014.
To learn more visit coveredca.com