California Health Insurance
Health insurance in California is changing dramatically, thanks to the Affordable Care Act. Californians can now purchase health insurance plans on the state-run health insurance marketplace, Covered California. California also expanded Medicaid (Medi-Cal) coverage to any non-elderly Californian who earns less than 138 percent of the federal poverty level.
As of April 2014, more than 3 million Californians have signed up for health insurance plans through Covered California.
What is a health insurance marketplace?
The marketplace is a website where consumers can find health insurance plans, provided by private insurers, that are compliant with federal health care reform law. You can apply for an Affordable Care Act-approved plan and Medi-Cal through the Covered California website during open enrollment.
Insurers cannot deny coverage or charge policyholders higher premiums based on pre-existing health conditions, and insurers have limits on charging out-of-pocket costs. Plans must cover 10 categories of essential health benefits, such as prescriptions and maternity care.
Do I qualify for a health insurance subsidy?
If you purchase a plan through the exchange and you earn between 100 and 400 percent of the federal poverty level – between $11,490 and $45,960 for an individual and between $23,550 and $94,200 for a family of four – you may qualify for a subsidy. This will come in the form of a tax credit that will cover part of your premium. However, if you qualify for affordable health insurance elsewhere, such as from an employer, you most likely won’t be eligible for financial assistance.
Health insurance companies participating in Covered California
- Anthem Blue Cross of California
- Blue Shield of California
- Chinese Community Health Plan
- Contra Costa Health Plan
- Health Net
- Kaiser Permanente
- L.A. Care Health Plan
- Molina Healthcare
- Sharp Health Plan
- Valley Health Plan
- Western Health Advantage
Medicaid qualification will typically be determined using 2014 federal poverty level limits, and subsidies will be determined using 2013 limits. As part of the Affordable Care Act, California expanded Medicaid (Medi-Cal) to adults who earn less than 138 percent of the federal poverty level. In 2014, this would be a person who earns $16,105 or less. You can apply for Medi-Cal through the Covered California website.
Medi-Cal also provides health, dental and vision benefits to uninsured children in California.
Children’s Health Insurance Program (CHIP)
Since January 2013, families who were enrolled in the California Healthy Families Program were moved over to Medi-Cal (with no loss of benefits).
California health statistics
California population (2013): 38,332,521
Population 65 and older (2012): 12.1 percent
Life expectancy (2010): 80.8 years
Number of Medicaid beneficiaries (2012): 7,305,300
Number of Medicare beneficiaries (2012): 3,802,500
Estimated number of uninsured residents (2012): 7,106,100
Overall state health ranking: 21
Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.
Health insurance resources
California Department of Health Care Services: http://www.dhcs.ca.gov/Pages/default.aspx
Covered California (California’s health insurance marketplace): https://www.coveredca.com/
California Department of Insurance: http://www.insurance.ca.gov/
California Department of Aging: http://www.aging.ca.gov/
Kaiser Family Foundation: http://kff.org/tag/california/