Health coverage helps pay for medical costs. A health care plan has a set of services that the plan provider agrees to pay for if you need them, like when you see a doctor or go to the pharmacy.

One way to get health coverage is through government programs, like Medicare and Medi-Cal. Another way is through private insurance companies. The two main ways to get private health coverage are through your job, which is called employer-sponsored group health coverage, or by buying it on your own, called individual health coverage. You can buy an individual plan for yourself and for your entire family.

In the past, buying individual health coverage could be very difficult, especially for people with disabilities. Many people worried that they wouldn’t qualify for it and, even if they did qualify, they might not be able to afford the monthly payments (called premiums) or other fees, like copayments or deductibles.

However, this has changed. Now, private health coverage companies cannot reject your application because you have a health condition, and if you get your insurance through Covered California, there should be a private or public health plan you can afford.

This article is about getting health coverage through Covered California. It will help you understand:

  • If an individual plan is right for you
  • What services your plan will cover
  • How to choose a plan
  • How much you will have to pay for health care, and
  • How to sign up.

If you need more help in understanding individual health plans after reading this article, we recommend you talk to trained experts. Here are some good resources:

  • Covered California has a lot of great information introducing your options. You can also call Covered California at 1-800-300-1506 o 1-888-889-4500 (TTY).
  • Covered California has ayuda a nivel local and you can use the Online Chat feature if you want to copy-and-paste a record of what was said.
  • If you have a disability, talk to un/a planificador/a de beneficios to learn if you have additional options.
Changes in 2020

In 2020, new California subsidies for private coverage will help people pay for private insurance plans on Covered California. These new subsidies will especially help families that make between 400% and 600% of the Federal Poverty Guidelines (FPG) and are unable to get insurance through their employers. People in this income range won’t qualify for federal subsidies, but may qualify for California subsidies.

Also, if you don't have insurance in 2020, you might have to pay a tax penalty on your 2020 California taxes (due in April of 2021). If you have to pay it, the penalty will be 2.5% of your income or $695, whichever is greater.

DB101 articles and calculators will be updated for these changes on January 1, 2020.

Observación: DB101 da seguimiento a los cambios en el sistema de atención médica y a las leyes correspondientes. DB101 está actualizado y seguirá actualizándose según sea necesario. Para obtener más noticias acerca del sistema de salud, puede visitar Covered California.