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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.


November 2017 Archives


Lower Income, Repay Subsidy?

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Question: I had Covered California with a big subsidy in 2016 because of my low income. I lost my job in October, so my income will be even lower than it was when I applied for coverage. I am now eligible for Medi-Cal. Will I have to repay the premium tax credits that got this year?

Answer: No. You are still eligible for the tax credits you received last year. If your income later fell below the Medi-Cal eligibility level, you will not be required to repay the premium tax credit when you file your tax return.


Question: What is the advantage of signing up through Covered California, instead of directly through through Kaiser?

Answer: Your income may make you eligible for premium assistance and Covered California is the only place to enroll for health insurance coverage with premium assistance. When you apply through Covered California you agree to file taxes each year and to allow Covered California to access your tax records through the IRS. When you apply directly through a California health insurance carrier like Kaiser Permanente - referred to as an off-exchange enrollment - you are not asked to provide any income related information whatsoever. Off-exchange, you will find more available health plan, some that mirror the Covered California plans exactly in benefits and rates, and other plans that are unique to the off-exchange-market.


Question: My son, age 23, got hired and enrolled in a PPO health plan at work, because they told him had to. He is still our plan. Can he drop his insurance through work and stay on our plan?

Answer: Your son can be included in your household health coverage through Covered California until age 26, even though he is employed. However, if he is included with your family coverage, your household is not eligible for premium assistance or cost sharing enhancements from the time he was offered health insurance at work.


Recover Covered Ca Password?

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Question: How do I recover a new password for my CoveredCA account?

Answer: Go to the Covered California Online Account, click here. Enter your username if you know it, if not click on “Forgot Username” You can recover your username with your email address and date of birth. To reset your password, click “Forgot Password”. After you correctly answer your security questions, you will be able to enter a new password. If you do not remember the answers to your security questions, it is best to leave them unanswered and call the Covered California Service Center at (800) 300-1506. A Service Center representative can help reset your password.


Covered California for 65+?

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Question: I turn 65 in February and I will be eligible for Medicare. Can I stay in Covered California instead?

Answer: You cannot purchase a Covered California health plan with premium assistance if you are eligible for Medicare. Without premium assistance, coverage through Covered California for a 65 year-old is much more expensive than Medicare. However, if your income is very low, you may be eligible for Medi-Cal in addition to Medicare. The Covered California application automatically checks to see if consumers qualify for Medi-Cal. If you qualify for both Medicare and Medi-Cal, Medi-Cal will help pay for Medicare premiums and cost-sharing requirements. Medi-Cal may cover additional benefits, such as dental services, nursing home care, and personal care services. Medi-Cal may also provide extra financial assistance to help with the cost of Medicare Part D prescription drug coverage.


Am I Renewed or Not?

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Question: I received a renewal notice from Covered California a while back. It seemed to say that I needed to renew my coverage by November 15th, but it also seems to say that I don’t have to do anything and I will be renewed. Which is it?

Answer: If you take no action to actively renew or change plans, you will automatically be renewed into the same plan you had in 2017 if available. However, you still have until December 15th, 2017 to make changes to your coverage or switch health plans.


Adult Child Coverage?

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Question: I thought my daughter could stay under Covered California plan until she is 26 years old? I was told that she had to be a dependent on my taxes. Is this correct?

Answer: If you are eligible premium assistance (a subsidy) for your family and wish to include your daughter as part of your household, she must be a dependent on your income tax return. If you are not eligible for premium assistance, your adult child can be financially independent and pay their own taxes and still be included on your family coverage to age 26.


Avoid Subsidy Overpayment?

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Question: My income went up during the year, si I guess I’ll have to pay some of the subsidy back. How do they handle that?

Answer: If you are paid too much premium assistance during the year, the IRS will recover some of it through your tax return. The subsidy overpayment is added to your taxes due for the year. You can avoid having to repay excess premium assistance in several ways.

    • If your income increases during the year, update your Covered California account to reflect the income change and your subsidy will be reduced going forward.
    • You can elect to take less premium assistance on a monthly basis or
    • you can take all of your premium assistance in a lump sum at the end of the year.

Quit Covered California?

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Question: I have an Anthem Blue Cross plan through Covered California, but I want to change to a Blue Shield plan outside of Covered California for 2018, since I don’t qualify for premium assistance. Do I have to notify Anthem so that they won’t automatically renew my plan for 2018?

Answer: Yes. It is your responsibility to notify Anthem that you are cancelling your coverage effective 12/31/2017. You must also terminate coverage in your Covered California account. To apply directly to Blue Shield, click here.


Question: I no longer get a subsidy. Is covered California just for people who qualify for subsidies? If so, how do higher income people apply?

Answer: If you are not eligible for financial assistance, it would be better to purchase coverage outside of Covered California (referred to as “off-exchange”). The reason? Silver plan rates for 2018 are 13% higher through Covered California. While Covered California Bronze, Gold, and Platinum Plans are the same price, you will pay more for Covered California Silver Plans. Click here to shop and apply for off-exchange health insurance coverage


Instead of COBRA?

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Question: I will be getting laid off effective 12/31/17, so if I elect, my COBRA coverage would begin on 1/1/18. Can I get covered under Covered CA instead? When would I need to sign on with Covered CA if my job and coverage ends on 12/31/17?

Answer: Yes. You can choose Covered California instead of COBRA. You must apply by December 15, 2017 for your coverage to begin on January 1,2018. You don’t have to wait for your current coverage to end.


Drop Company Plan for Covered CA?

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Question: I make $50,000 a year and my husband makes less than $20,000 a year. He’s currently on my insurance plan through my employer, but it has gotten too expensive and we cannot afford it. I wanted to see if he can apply for covered California on his income alone.

Answer: Your spouse is ineligible for premium assistance (subsidy) through Covered California because he has access to your employer’s health plan. He can off exchange insurance coverage without a subsidy, but the cost may be similar to spouse coverage under your employer-based coverage. Your incomes have no effect in this case.

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