ObamaCare in California: What you need to know about Covered California

You’ve probably been hearing more buzz than usual about ObamaCare these past few weeks.  On October 1, 2013, California’s health care exchange, called “Covered California,” will open for business.  ObamaCare’s individual mandate will take effect on January 1, 2014, but people can only buy coverage in California between October 2013 and March 2014.  Miss that window and you’ll be out of luck until it reopens in 2015.health insurance

With the time ticking, many people are rushing to learn more about what is available, how much it will cost, and how to get coverage.  The health care exchanges vary from state to state, and in California, we will be dealing with Covered California.  There are currently 12 different companies authorized to provide benefits under Covered California for 2014.  They are: Alameda Alliance for Health, Anthem Blue Cross of California, Blue Shield of California, Chinese Community Health Plan, Contra Costa Health Plan, Health Net, Kaiser Permanente, L.A. Care Health Plan, Molina Healthcare, Sharp Health Plan, Valley Health Plan and Western Health Advantage.  However, not all twelve companies will be providing state-wide coverage.  That means that, depending on where you live, you could be able to select from only 1-5 of the twelve companies.  If you are limited to only one company to select from, you will have options within that company to purchase a plan that works well for you and your family.

All of the companies authorized to provide coverage under Covered California will offer four tiers of service plans.  The tiers are Platinum, Gold, Silver and Bronze.  Each tier will cover a different percentage of your medical bills, but also comes at a cost.  A plan that covers 90% of your bills, for example, will be more expensive than one that covers only 60%.  You will have the ability to select whichever tier you would like without discrimination for preexisting conditions.

Another feature meant to bring equal coverage to all is that the insurance providers must, by law, provide the same benefits to all.  What this means is that once company can’t charge $45 for an office visit copay while another company charges $75.  It also means that you will no longer be charged a higher premium due to your current state of health or pre-existing conditions, and that the insurance company cannot deny you coverage for a particular treatment unless it denies that coverage to everyone.  Individual members cannot be singled out; benefits must apply to everyone or no one.

As far as the penalty taxes for not having coverage, in 2014, the penalties will be either a flat fee of $95 or 1% of your taxable income, whichever is greater.  The flat fee more than triples in 2015 to $325 or 2% of taxable income, and in 2016 it will increase to $695 or 2.5% of taxable income.


For more information about CoveredCA, feel free to contact one of our certified CoveredCA agents at Mertens Insurance or 1-888-503-7180. You can also come into one of our three locations in Lincoln, CA, Grass Valley, CA or Yuma, AZ. Follow us on Google+!

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