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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.

October 2019 Archives

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

Answer: You can recover your username and password at www.CoveredCa.com. To recover your username, click the “Sign In” icon at the top of the page, select “Forgot Username” and type in your email address and date of birth. If you ever created a username it will be provided. If no username, create an account. To recover password, select “Forgot Your Password?” link. Enter your user name and date of birth. 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.

Question: Covered California took my monthly premiums for 8 months. When I went to the doctor, they cut my benefits. When I asked them why they said because the law had changed in January 2019 and insurance was no longer mandatory. Then I asked for a refund for a refund of my premiums and they said no because I saw the doctor once!

Answer: Apparently your Covered California coverage did not renew on January 1, 2019. Most likely causes include non-payment of the monthly premium or loss of eligibility due to an income change. The premiums you paid prior to that date was to pay for coverage before January 2019, that’s why you can’t get a refund even though you only “saw the doctor once”. Do you get a refund of your auto insurance premiums when you don’t have an accident or your home insurance when your house doesn’t burn down? Health insurance works the same way. You pay for the protection against a major financial loss. Health insurance is mandatory in California in 2020. Now’s you chance to get it right, Sign up during Open enrollment October 15m 2019 to January 31, 2020.

Why an Open Enrollment Period?

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Question: Why is there an open enrollment period to buy health insurance? Wouldn’t anytime be better?

Answer: Wouldn’t it be great if you could purchase health insurance on Amazon when you need it — when told you need an MRI or from your hospital bed right after the accident. But if we all did that, the insurance company would not collect enough money to pay for everybody’s claims. So everybody has to put money into the pot all year long to make it work. The young and the healthy help pay for the old and sick.

Outside of the Open Enrollment Period (October 15 - January 31), people who need health insurance can enroll through Special enrollment with a qualifying life event such as loss of work related insurance, marriage, birth of a child. etc.. Those who are eligible for Medi-Cal can enroll anytime during the year.

Age 26 Enrollment?

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Question: Our son turns 26 in April 2020. Can he enroll in his own medical insurance during the current open enrollment period or must he wait for 2021?

Answer: Your son will qualify for a Special Enrollment Period triggered by his 26th birthday. He can wait until then to enroll in his own plan. Or he can enroll in his own plan during this Open Enrollment Period and have his own coverage start on January 1, 2020.

Changes to Income Impacting CSR?

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Question: I'm going to start 2020 unemployed, so estimating income is tricky. I understand the premium assistance gets trued up at the end of the via taxes. What happens with CSR (silver 73 vs 87 vs 94) based on income changes. If I had short term income, would that move me to a different co-pay structure right away?

Answer: Cost Sharing Reductions (CSR) are not charged back at year end due to unplanned income changes. The CSR level at the start 2020 will not change unless you manually adjust your income in your Covered California account during the course of the year.

No Income Coverage?

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Question: I am not working and have no other income. I need to keep my hematologist. Can I receive Covered California and choose a plan which I would pay out of pocket or do I have to take MediCal since I believe I fall into the poverty level.

Answer: If you have no income, you have two options for health insurance coverage. (1) you qualify for Medi-Cal coverage which has $0 cost for both the insurance and out-of-pocket expenses, but your current doctors may not accept Medi-Cal. Ask you doctor if he will continue treating you if you switch to Medi-Cal. (2) You can purchase individual coverage directly from any California licensed insurance company that your doctor accepts, but not Covered California. You will face significant expense both in monthly insurance premiums and out-of-pocket medical expenses that will probably be unaffordable. I recommend going with Medi-Cal even if you have to change doctors.

Question: My wife petitioned her mother who lives in Mexico to live come to the US to live with us as a resident, but I heard there is a new immigration law that's going to be in effect starting November 3rd for all new immigrants have to have health insurance before or within 30 of entering the US. But they can not use the exchange's or Medi-Cal assistance. Where can we purchase health insurance for her. She won't have Medicare either.

Answer: Right. The White House issued a presidential proclamation on October 11, 2019 requiring many future immigrant visa applicants to show they can afford health care. The action, which is set to take effect in 30 days, would require immigrant visa applicants, including people with ties to family members in the U.S., to show they have health insurance or prove their financial ability to pay for medical care before being issued a visa that could lead to a green card.

The most affordable option for health insurance coverage for a visa applicant is international travel insurance for foreign nationals traveling to the United States. Shop Patriot America® Plus. The policy can cover up to two years with renewals for additional two years at a time. Monthly rates as low as $300 per month. Option number two is individual health insurance from a California insurance carrier at a minimum of $600 per month. Immigrant visa applicants are not eligible for premium assistance through Covered California or Medi-Cal.

Question: I have my health insurance with Blue Shield through Covered California. If I want to keep my current plan do I have to do anything during Open Enrollment?

Answer: Blue Shield will automatically renew you for 2020 coverage in the health plan you have now. If your current plan is no longer available, Blue Shield will automatically enroll you into a similar health plan. Even if you have been automatically re-enrolled you can still make changes to your health plan coverage until January 15, 2020.

If you receive premium assistance for your health insurance coverage through Covered California you should validate your enrollment online at or by phone at 800-300-1506 between October 15 and December 15, 2019 to maintain your financial assistance.

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