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Covered California

by: SMCMAApril 24, 2014
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What Is Covered California?

To help those without health insurance get covered, the Affordable Care Act included a requirement that states either set up their own marketplace for people to buy health insurance or have one set up by the federal government. California chose to set up its own marketplace — Covered California™ — as its doorway to health coverage. California also decided to expand its Medi-Cal program, and Covered California is the place for patients to go to find out if they are eligible. 

There are five plans in San Mateo County that are offering insurance through Covered California. Three are PPOs (Blue Shield of Calfiornia, Anthem Blue Cross, and Health Net) and two are HMOs (Kaiser Permanente Medical Group and Chinese Community Health Plan).

  

Covered California News and Resources for Physicians

In 2016, Covered California, California's health benefit exchange, enrolled approximately 1.4 million individuals in qualified health plans. It is critical that physician practices understand their participation status, which products are being offered and what changes to expect in 2017. 

Some of the most significant changes for Covered California in 2017 are:

  • All Covered California enrollees, including those with a PPO or EPO, will be assigned to a primary care physician. The assignment will either happen by January 1, 2017, or within 60 days of the enrollee’s effective date with the plan.
  • United Healthcare will exit California’s exchange marketplace at the end of 2016, impacting approximately 1,200 enrollees. All other plans that offered coverage in 2016 will continue to do so in 2017.

Click here to download Surviving Covered California: Preparing for changes in 2017.



Covered California Resources

California's Health Benefit Exchange (HBEX) - Powering Covered California

HBEX: Resources for Providers

HBEX: Enrollment Partner Toolkit

HBEX: Covered California Regulations

Covered California Consumer Website

California Department of Health Care Services

CMA news related to Covered California.

"Covered California 101" On-Demand Webinar (November 2013 - free)

"Surviving Covered California: What Physicians Need to Know" On-Demand Webinar (May 2014 - free to members; $99 for all others)