The Affordable Care Act establishes state marketplaces, where individuals and small businesses can shop for health insurance. The health insurance marketplace for California is called Covered California.
As of January 1, 2014, health insurance companies must accept consumers who apply for coverage regardless of health, age, gender or other factors (including pre-existing conditions). Individuals may get financial assistance to make coverage more affordable and be able to compare and choose health coverage that best fits their needs and budget. Subsidies will only be available via Covered California to individual consumers who qualify.
Individuals and Families will only be able to purchase health insurance during annual open enrollment period. The 2019 open enrollment period for an individual to apply for coverage runs from November 1, 2018 through January 31, 2019. All eligible Californians will have the opportunity to purchase an individual and family plan during this three-month period with guaranteed acceptance.
After January 31, 2018, consumers will not be able to enroll in a health plan until 2019 unless they experience a qualifying event, such as:
- Reduction of hours or termination of employment (for other than gross misconduct)
- Divorce from or death of the subscriber
- The subscriber’s entitlement to Medicare
- A child’s meeting the age limit for coverage (i.e., 26)
- Loss of minimum essential coverage
- New dependent
- Acquire citizenship
- An enrollee is determined newly eligible or newly ineligible for advanced premium tax credit (APTC) or has a change in eligibility for a cost-sharing reduction plan
- An individual whose existing coverage through an eligible employer-sponsored plan will no longer be affordable or provide minimum value
- Recently released from incarceration