Deciding What You Want And Need
Step 1: Determine if you have employer-based insurance for which you or relative's employer is paying. If you do, you will be expected to accept it and NOT enroll in Covered CA. If you do not have employer-paid insurance or you are uninsured you will be able to enroll in Covered CA.
Step 2: Determine if you will be eligible for financial assistance by visiting Covered CA's cost calculator.
Step 3: Decide which level of benefit you want: Bronze, Silver, Gold, Platinum
- All 4 levels provide the same actual medical services.
- The lower the premium (your monthly cost) the more you will pay, out of your pocket, when you seek services.
- The Bronze level offers the lowest monthly premium but the highest out-of-pocket costs should you need services.
- The Platinum level offers the lowest out of pocket costs, but the highest premium.
- Financial assistance in paying premiums is available at all the levels.
- But financial assistance for paying you out-of-pocket costs is available ONLY at the Silver level.
Step 4: Select a health plan (insurance company)
- All insurers offer all metal levels: bronze, silver, etc.
- Premiums charged by the companies will differ
Step 5: Enroll. For assistance go to Covered CA Enrollment Assistance or call 1-888-975-1142.
Which Level of Benefit is Right for You?
There is no easy answer to this question, but consider the following:
- The Bronze level has the lowest monthly premium, but it has the highest cost sharing—meaning you will pay a higher cost (or co-pay) for each visit to a doctor, for example. If you have few medical expenses in a year it will have proven to be a good choice. But if you have significant expenses over the year this plan may end up costing more, not less.
- The Silver level is the only one in which subsidies for cost-sharing expenses are available. That means you pay a lower cost for each visit to a doctor, for example. If you have a low-income, qualifying for financial assistance, this plan may be right for you, especially if you expect to have significant medical expenses.