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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Private Insurance for my Child?

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Question: I am self employed. Acceptance by physicians for Covered CA plans are different for me and for my 8-year-old child: my child's physicians do NOT accept ANY Covered CA plans, while mine do. Can I stay on my Covered CA plan and purchase an off-exchange plan for just my child? We don't qualify for a subsidy.

Answer: Yes. You can do that during open enrollment - November 1, 2015 through January 30, 2016 - when you may update your Covered California account to indicate that your daughter, though part of your household, is not requesting coverage. Then you can apply for coverage for her directly with an insurance carrier effective January 1, 2016.

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You would be best advised to find a single health plan in which both your physician and your child’s physician are in the same network (or a PPO, in which case some expenses might be out-of-network and subject to different cost-sharing).

Using the services of an agent to assist in this search of provider directories is free and could be beneficial. Because multiple plans must coordinate things like deductibles and out of pocket maximums, being insured under different plans puts the burden on you to keep track of expenses and payments that a single insurer normally does for you.

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