Covered California Deals From ‘No Brain’ to Sticker Shock

If you buy your own health insurance, it’s time to choose coverage for 2022. If you buy through Covered California, your chances are better than ever that you’ll get a big discount on your monthly premium – or no insurance premiums.

Many middle-class families who previously paid the full fare for their health plans were financially supported this year through American rescue plan, a law that significantly expanded federal tax credits to reduce the premiums consumers pay.

But hundreds of thousands of Californians who qualify for the credits have yet to reap the benefits. Follow estimate from Covered California.

“It’s a lot of money that people don’t realize they’re leaving on the table,” said Peter Lee, chief executive officer of Covered California. “I don’t know anyone who can comfortably transfer $10,000.”

Enrollment for 2022 coverage through Covered California – as well as personal and family health plans purchased off the exchange – ends January 31. Consumers can sign up at any time. in the year if they have been through big life change, such as losing a job, moving house, having a baby, getting married, or being affected by a natural disaster.

The additional federal tax credits are expected to expire by the end of 2022, but the current version of President Joe Biden’s roughly $2 trillion Build Back Better legislation, is pending approval in Congress extend them to 2025.

If you’re already in a Covered California plan that you like, you can simply renew it without checking other options. Resist that temptation. Insurers change their prices every year, and new companies may have entered the market in your area. So another health plan may be a better solution than your current plan.

But if you like health providers in your current network, make sure you’ll have access to them in any health plans you consider for next year.

The American Rescue Plan not only provides many Californians with significantly cheaper insurance premiums, but it also offers free Cadillac insurance if their income is low enough.

In general, individuals and families with annual incomes between 138% and 150% of the federal poverty line — $17,775 to $19,320 for an individual and $36,570 to $39,750 for a family of four — have can get the lowest coverage, called bronze, for no monthly premium in 2022. But they also won’t have to pay premiums if they choose a particularly generous plan called silver- ninety four. The individual version of the plan has a deductible is only $75, there’s no deductible for prescription drugs, and an annual $800 limit on out-of-pocket enrollees before paying 100% of their medical expenses. In the co-plan, in comparison, the medical deductible for an individual is $6,300, with an out-of-pocket spending limit of $8,200 and a private pharmacy deductible of $500.

Covered California and all of their salt-worth insurance agents are encouraging people in co-plans who meet the zero premium income criteria to make that switch.

“I call it a no-brainer scheme,” said Edsel D’souza, a partner at Citrust Insurance in Culver City. “When people hear about it, they can’t believe how good it is.”

But not everyone who enrolls at Covered California has a happy surprise waiting for them. Under a provision in the American Rescue Plan, about 120,000 people sign up for a 94-silver package with a salary of $1 a month this year if they receive even one week of unemployment benefits in 2021. Many – and perhaps all – of those subscribers who will lose that discount in 2022 and are either facing the shock or preparing for a return to lower coverage.

Kevin Knauss said: “I had people who used to be bronze, unemployment was going up, and we moved them to silver 94, so now they’re running around completing all kinds of tests and processes. before the end of this year. , an insurance agent in Granite Bay.

D’souza says he’s helped a family of four, where one of the parents received unemployment benefits for part of 2021, enable them to transition to a Covered California program that costs $344 each. month. But they won’t be subsidized in 2022, D’souza said, and monthly premiums will nearly quadruple, to $1,269.

By D’souza’s calculations, a 40-year-old single person living in West Los Angeles has an income of $40,000 and is paying $1 a month in 2021 for a 94 silver plan after being unemployed for a year. will see monthly premiums rise to nearly $200 by 2022 — for a much less generous silver plan.

Shopping for and signing up for coverage with Covered California can be complicated, and it’s not hard to run into problems.

Knauss notes, for example, that Covered California looks at your income for the month you apply. If you apply in December and don’t have any income this month, you could be pushed into Medi-Cal, the government-run insurance program for low-income people, even though your income is low. Your annual income is above the eligibility threshold. Reverting to Covered California can be time consuming and frustrating.

Another common problem, Knauss says, affects people with employer insurance that ends December 31. If this applies to you, be aware that you won’t get benefits. for 2022 if you fill out your application this month and tick “yes” when asked. whether you have work-based insurance. You need to check for “no” even though that wasn’t technically true at the time, says Knauss.

To avoid some of these pitfalls, find an insurance agent in your area who will walk you through all of the options. The agent will not charge you a dime.

You can find an account on the Covered California website ( You can also fill out a form on the website to receive a quick phone call from an insurance agent or other certified exchange enrollee. And you can get help with enrollment by calling Covered California at 800-300-1506.

A word of warning: Some sites imitate Covered California but their purpose is usually to create business contacts for insurance agents.

Jonathan Edwards, D’souza’s business partner at Citrust, said one of his clients thought he was filling out an application with Covered California and then received 20 calls from insurance agents. within an hour. “You have to know that is the official website of Covered California,” Edwards said, “and everything else is in doubt.”

This story is produced by KHN, publish California Healthline, an editorially independent service of California Health Care Foundation.

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