STEP BY STEP
We’ve got you covered.
Covered California is where Californians can shop for and compare quality health plans among a variety of brand-name insurance companies. You may even get help paying for it. This guide will help you better understand your coverage options so you can enroll in the health plan that best fits your needs.
We’re here to help.
LK Health offers no charge for in person Covered California Enrollment help.
See if you qualify for help paying for health coverage
Based on your annual household income, you may qualify for what’s called an Advanced Premium Tax Credit (APTC) to help reduce your monthly premiums. Or you may qualify for low or no-cost coverage through Medi-Cal.
Explore your coverage options
Covered California offers four levels of coverage: Bronze, Silver, Gold and Platinum. Insurance companies pay a portion of covered services, and the benefits offered within each level are the same no matter which insurance company you choose.
• Choose Platinum or Gold and you’ll pay a higher monthly premium, but you’ll pay less for medical services.
• Choose Silver or Bronze and you’ll pay a lower monthly premium, but you’ll pay more for medical services.
• A minimum coverage plan is available to those under 30 or those 30 and over who have received a hardship exemption from U.S. Department of Health and Human Services.
|Standard coverage benefits by level|
What you need to enroll
The following is needed for every household member who is applying for coverage:
Proof of current household income*
California ID or driver’s license for adults
Home ZIP Code
Social Security number or Individual Taxpayer Identification number, if you have one
Proof of citizenship or satisfactory
immigration status (e.g., U.S. passport, legal resident card, certif¡cate of citizenship or naturalization document)**
As part of the ACA, Covered California is a program where most legal residents of California and their families can compare quality health plans and choose the one that works best for their health needs and budget. The law requires that:
• Preexisting health conditions cannot prevent someone from being covered.
• Your plan cannot be cancelled because you are sick or injured.
• Young adults can be covered under their parents’ plan until the age of 26.
• All plans include free preventive care.
Most people are required by law to have health insurance or pay a tax penalty. In 2018, the penalty is $695/adult, $347.50/child under 18 (up to $2,085/family) or 2.5% of your annual household income over your tax filing threshold, whichever is higher.
Most insurance companies offer three types of plans:
Health Maintenance Organizations only cover medical services inside the plan’s network. HMOs often require members to get a referral from their primary care doctor to see a specialist.
Preferred Provider Organizations pay for medical services both inside and outside the plan’s network, but members pay a higher amount of the cost for out-of-network care. No referral is required to see a specialist.
Exclusive Provider Organizations generally don’t cover care outside the plan’s network, but members may not need a referral to see an in-network specialist.
It’s important to note that not all HMOs, PPOs and EPOs are the same. Before choosing a plan, your LK Health Enrollment Counselor can obtain details for you such as what doctors and hospitals are covered and what it will cost to see a doctor out-of-network.
* Proof of current income of all members in the tax household, such as a recent tax return, W-2, or pay stub. A dependent’s income should only be included if their income level requires them to file a tax return. A household is defined as the person who files taxes as the primary tax filer and all the dependents claimed on that person’s taxes. If you don’t file taxes, you can still qualify for free or low-cost insurance through Medi-Cal.
** You can apply for your child even if you are not eligible. Households that include members who are not lawfully present can also apply.
Enroll in your plan at LK Health.
As always, we’re here to help. If you have questions or to find free, local, in-person help, please visit LK Health or call (323) 728 – 8588
Pay your premium
Be sure to pay your monthly premium in full and on time to ensure that your coverage continues. Failing to pay your premium may disrupt or even cancel your health coverage.
For more information or to find free, confidential local help, please contact:
(323) 728 – 8588