Take advantage of covered California insurance offers – Monterey Herald

If you’re buying your own health insurance, it’s time to choose your coverage for 2022. If you buy it through Covered California, there’s a better chance than ever that you’ll get a big discount on your monthly premium – or pay. no premium at all.

Many middle-class families who previously paid full price for their health plans got financial help last year through the American Rescue Plan, a law that significantly expanded federal tax credits that reduce the premiums paid by consumers.

But hundreds of thousands of Californians eligible for credits are yet to reap the benefits. Among them are 575,000 uninsured people, most of whom could get coverage for $ 0 per month, and about 260,000 people who buy insurance outside of the state’s Affordable Care Act market and could save money. hundreds of dollars a month by opting in, according to estimates from Covered California.

“It’s a lot of money that people don’t realize they’re leaving on the table,” says Peter Lee, executive director of Covered California. “I don’t know of anyone who can easily send $ 10,000. “

Enrollment for 2022 coverage through Covered California – as well as for individual and family health plans purchased outside of the exchange – ends January 31. Consumers can enroll at any time of the year if they’ve undergone a major change in their life, 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 at the end of 2022, but the current version of President Joe Biden’s approximately $ 2 trillion Build Back Better legislation, pending in Congress, would extend them until 2025.

If you already have a covered California plan that you like, it can be tempting to just renew it without checking out the other options. Resist this temptation. Insurers change their rates every year and new companies may have entered the market in your area. So a different health regimen might be a better deal than your current regimen.

But if you like the medical providers in your current network, make sure you have access to them in any health plan you are considering for the next year.

The American Rescue Plan not only gives many Californians significantly cheaper premiums, but also makes Cadillac coverage available for free 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 one person and $ 36,570 to $ 39,750 for a family of four – can get the lowest level of coverage, known as bronze, for no monthly premium in 2022. But they also wouldn’t pay any premium if they chose a particularly generous plan known as silver-94. The individual version of the plan has a medical deductible of just $ 75, no prescription drug deductible, and an annual cap of $ 800 on how much registrants pay out of pocket before 100% of their medical bills are covered. In the Bronze plan, by comparison, the medical deductible for an individual is $ 6,300, with a reimbursable expense limit of $ 8,200 and a separate drug deductible of $ 500.

California Covered and all insurance agents worth its salt are encouraging people with Bronze plans that meet the zero premium income criteria to make this switch.

“I call it the obvious plan,” says Edsel D’souza, partner of the Citrust Insurance Agency in Culver City. “When people hear about it, they can’t believe it’s that good. “

But not all Covered California registrants have such a happy surprise ahead. Under a provision of the US bailout, about 120,000 enrollees got the money-94 plan for $ 1 a month this year if they received unemployment benefits even for a week in 2021. Many – and possibly – be all – of those registrants will lose this reduction in 2022 and face sticker shock or bracing for a return to a lower level of coverage.

“I have people who were in the bronze, who got unemployment aid, and we replaced them with 94 money, so now they’re running around doing all kinds of tests and procedures before the end of the day. ‘year,’ says Kevin Knauss. , an insurance agent in Granite Bay.

D’souza says he helped a family of four one of whose parents received unemployment benefits during part of 2021, allowing them to switch to a covered California plan that cost $ 344 per month. But they won’t receive any grants in 2022, says D’souza, and the monthly premium will almost quadruple, to $ 1,269.

According to D’souza’s calculations, a 40-year-old single person who lives in West Los Angeles has an income of $ 40,000 and pays $ 1 per month in 2021 for a Money-94 plan after being unemployed during part of the year. would see the monthly premium drop to almost $ 200 in 2022 – for a much less generous money plan.

Shopping and getting coverage with Covered California can be tricky, and it isn’t hard to run into issues.

Knauss notes, for example, that Covered California looks at your earnings in the month you apply. If you apply in December and have no income this month, you could be pushed into Medi-Cal, the government-run insurance program for low-income people, even if your annual income is is above the eligibility threshold. It can be long and frustrating to get back to California covered.

To avoid some of these pitfalls, find an insurance agent in your area who will explain all of the options to you. The agents won’t charge you a dime.

You can find one on the Covered California website (www.coveredca.com). You can also fill out a form on the site to get a quick phone call from an insurance agent or other exchange approved recruiter. And you can get help with registration by calling Covered California at 800-300-1506.

A word of warning: Some websites emulate the Covered California site, but their goal is generally to generate leads for insurance agents.

Jonathan Edewards, D’souza business partner at Citrust, said one of his clients thought he was filling out an application with Covered California, then received 20 calls from insurance agents in an hour. “You should know that coveredca.com is the official website for Covered California,” Edewards says, “and everything else is suspect.”

This story was produced by KHN, which publishes California Healthline, an independent editorial service of the California Health Care Foundation.


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