In anticipation of 2016’s health insurance Open Enrollment season, here is the CoveredCA 2016 Benefit Grid showing the differences between the various plans offered. Some quick notes on how to read these benefits:
The first 2 plans (Bronze, Silver) and the last 2 plans (Gold,Platinum) are going to be the plans applicable to the majority of people
Only those earning within certain income limits have access to the Enhanced Silver programs. These brackets can be viewed in the third row of the chart, or we can help you calculate this by filling out the 2016 Benefit Request Form
These programs will be the same regardless which carrier you choose. A Silver plan from Blue Shield will be the same as one from Anthem
The exception to the above is A)network and number of doctors available B) how you access the care (HMO vs. PPO) and C) pricing and customer service.
Any California resident can purchase a plan, but only those earning under certain income thresholds can get assistance paying for the coverage. Those who are under 400% of the FPL may be eligible. Again, refer to the 2016 Benefit Request form if you’d like assistance calculating this.
If you are too far under the FPL, you’ll be eligible for Medi-CAL and ineligible to purchase a CoveredCA plan with subsidies. You can turn down Medi-CAL but then you would have to purchase a health plan at full price, no premium assistance is available.
Remember, if you have any questions, using a CoveredCA Certified agent to help you enroll does not cost anything extra. An agent’s relationship goes much further than the initial enrollment. They help with claims disputes, payment, future benefit comparison, and any other issue you may have without having to call endless 800 lines to try to reach an actual human being to help resolve your problem. Open Enrollment officially began Sunday, November 1, for a January 1, 2016 effective date.