What You Need to Know
You can sign up for California health insurance plans from November 1 to January 31.
Health coverage depends on when you enroll in a plan.
Always shop around during open enrollment. You may find better prices with a new insurer. Also, a change in income could affect any subsidies you receive to pay for premiums.
Under California’s Covered California, the open enrollment window to buy Affordable Care Act (ACA) health insurance stretches about three months longer than any other state, from November 1 to January 31.
Covered California is the state-run health insurance marketplace created for individual citizens and small businesses to buy private health insurance at federally subsidized rates. Between 2019 and 2020, premiums only increased by 0.8%. This is the lowest change since Covered California launched and is due to new state affordability initiatives designed to lower costs and encourage enrollment.
What Is Open Enrollment?
During Open Enrollment, everyone can join a health insurance plan, often called Obamacare or ACA plans. These plans are regulated by the federal government and require insurance companies to offer them at the same cost to people with pre-existing medical conditions. Also, insurers are barred from rejecting anyone.
Coverage begins based on the time you enroll:
- If you sign up by December 15, 2020, your coverage will start on January 1, 2021.
- If you sign up by January 15, 2021 your coverage will start on February 1, 2021.
California’s open enrollment stretches for a third of the year, far longer than other states, which start in November.
How Can You Get Health Insurance During California’s Open Enrollment?
You can join a plan on or off the state-run Marketplace. You can select plans on your own, get help from a locally-licensed insurance agent or go to HealthCareInsider.com, connecting you to independent insurance agents at no extra cost to you. Or call 833-962-2720.
What Are Health Insurance Costs In California For 2021?
Nationwide, the cost of health insurance premiums – the amount you pay each month for coverage – are slowing down after record highs. This is mainly due to competition, as more insurance companies join the ACA marketplace. However, keep in mind that these savings are often offset by rising deductibles – the amount you pay for medical care before your insurance company pays anything.
Californians can choose from several health insurance companies that offer subsidies. Higher-income people who didn’t qualify for Obamacare subsidies saw their premium costs rise about 8% each year to over $500 a month compared to around $120 for subsidized individuals. But overall in 2020, the monthly premium increases were kept to only 0.8%. The reason, or part of it? Penalties paid by people without insurance lowered the costs for those who enrolled in an insurance plan.
What Happens If You Miss Open Enrollment?
Special Enrollment Periods: You can enroll in a plan outside the enrollment period if you have a qualifying life event. These events include moving to a new ZIP code, losing health coverage at work, joining Medicaid, aging off your parents’ plan, and having a baby or adopting a child.
No Temporary Health Plans: California has banned short-term health insurance plans since 2018. However, about 30 states allow these limited option plans that usually run for 90 days but can be renewed for up to three years. The low-cost plans can provide a useful safety net against medical emergencies as people seek better comprehensive coverage. Still, they don’t accept anyone with a pre-existing condition, as well as other significant drawbacks.
What Is Obamacare?
The ACA, or Obamacare, sets minimum standards for private health insurance plans, including requiring coverage for 10 essential health benefits and prohibiting additional fees for those with pre-existing conditions.
Most health insurance plans share the same basic design. They have monthly premiums, deductibles, and copayments, which are set amounts charged for office visits, coverage of medications, and certain procedures. They also have different plan types – like HMOs or PPOs – regulating how many doctors are on your plan. An HMO typically has cheaper premiums and copayments but restricts you to a limited number of doctors, hospitals, and other providers. A PPO is usually more expensive but provides a much wider set of providers.
How Did California Get Its Long Open Enrollment Period?
California is one of 13 states that runs its insurance website instead of relying on the federal government’s healthcare.gov platform. This allows California to exercise far more control over local health insurance, including signup dates and penalties.
When Obamacare first became law a decade ago, officials expected that the open enrollment period would shorten over time from 26 weeks to 45 days as more people got insured. After the 2016 presidential election, the Trump administration reduced the open enrollment period for federally run marketpaces.
States that controlled their ACA marketplaces did the opposite. For 2018 open enrollment (which took place in 2017), 10 states increased their open enrollment periods. In 2018, California extended the final deadline to January 31.
California Assemblyman Jim Wood proposed a bill to permanently extend California’s Open Enrollment Period before the Trump administration acted. Wood’s measure, AB-156, was introduced in January 2017. It passed the California Assembly and Senate unanimously that summer, and Governor Jerry Brown signed it into law on October 4, 2017 for plans beginning in 2018..
This law has contributed largely to the state’s low uninsured rate. According to the U.S. Census Bureau, California’s uninsured rate is 7.2%. By contrast, nearly half of the nation averages 13.7%. Experts attribute this positive outcome to California’s penalties, paid at tax time, by individuals who do not sign up for medical insurance. Still, California’s rate is far from the lowest in the country. Massachusetts’s rate is 2.8%, followed by Vermont at 4%. California, though, is still doing far better than many states, including Texas at 17.7% and Oklahoma at 14.2%.
Why Have Open Enrollment for Health Insurance Plans?
Insurance companies limit the time you can buy insurance so people can not wait until they are sick to buy insurance. Insurance companies would go out of business if they had to pay out more money in claims than they take in, so they need healthy people to buy insurance. An open enrollment period requires all people, healthy and sick, to purchase a plan in the same time frame.
To address the enrollment requirement, the ACA created the federal Open Enrollment Period. During this annual period, everyone in federal marketplaces has the opportunity to buy or re-enroll in health insurance.
Open enrollment is your best chance to:
- Purchase health insurance for the first time;
- Switch to a different insurance company;
- Change your health insurance plan type.
What About Medicare Enrollment In California?
The nationwide Medicare open enrollment is the same in every state, including California. The initial enrollment period starts three months before the month you turn 65 and ends three months after 65. Be aware. You should sign up for Medicare at least the month before you turn 65 to avoid suffering a health coverage gap.
Can You Get Health Insurance Subsidies in California?
Signing up to automatically renew your plan is generally a bad idea, because plans change constantly. It’s important to check each year to see that you’re getting the best plan for your medical needs and your budget. Studies show one or two hours of comparison shopping can save you money and get you a better plan. Also, automatically renewing can become problematic if your income changes. Premiums subsidies could disappear if your income climbs sharply. On the other hand, you could miss out on financial help during the year if you make less.
If you don’t qualify for an income-based subsidy, it’s usually cheaper to get a plan outside of the state marketplace. Off-exchange plans outside of Covered California are often cheaper than those sold through Covered California. But, bear in mind, they frequently offer less comprehensive coverage.
California opens the door for consumers to buy health insurance plans longer than any other state. Specifically, the open enrollment deadline to get a 2021 health insurance plan without hassle in California is January 31, 2021.
Covered California is the state health insurance marketplace created for individuals and small businesses to buy private health insurance at federally subsidized rates. According to Covered California, the rate change only increased by 0.8% in 2020. This is the lowest change since Covered California launched and is “due to new state affordability initiatives that are designed to lower costs and encourage enrollment.”